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Common in critically ill pts and may be as high as 88% in ICU pts
Neuromuscular instability leading to seizure, laryngospasm, bronchospasm, or resp arrest
Impaired cardiac function causing heart failure, hypotension, and dysrhythmias
Symptomatic hypocalcemia
Normal serum calcium content: 8.5–10.5 mg/dL.
With 40–50% bound to plasma proteins (albumin).
With 45–50% ionized (physiologically active).
With 10–15% nonionized, bound to inorganic anions such as phosphate, citrate, and sulfate.
Total calcium level related to albumin level and acid-base status affects the ionized calcium level.
Ιonized calcium level is the preferred measurement (normal: 4.75–5.3 mg/dL [1.19–1.33 mol/L]).
The physiologic role of calcium:
Neuromuscular signaling and muscle contraction.
Hormone secretion.
Cardiac contractility.
Blood coagulation.
Cell growth.
Transport and/or secretion of fluids.
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