Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders>>>>>Calcium, Phosphate, and Magnesium
Question 5#

A 67-year-old male is admitted to the trauma ICU for management of anaphylaxis. He is intubated for airway swelling. 3 hours from the onset of symptoms the patient is hemodynamically stable without a pressor requirement. Routine labs ordered show the following: 

Which of the following electrolytes require repletion?

A. Potassium, magnesium, and IV calcium
B. Potassium only
C. Neither potassium or IV calcium
D. Potassium and magnesium

Correct Answer is C

Comment:

Correct Answer: C

IV calcium replacement is recommended only when severe effects of hypocalcemia-like neurological symptoms (tetany and seizures), hypotension, prolonged QT interval, or in asymptomatic patients with an acute decrease in serum corrected calcium to ≤7.5 mg/dL. This patient does not meet criteria for treatment. 

Reference:

  1. Kraft MD, Btaiche IF, Sacks GS, Kudsk KA. Treatment of electrolyte disorders in adult patients in the intensive care unit. Am J Health Syst Pharm. 2005;62:1663-1682.