I have to credit Dr. Rishi Kumar for inspiring me on this ionized calcium in the ICU post this today. His post on instagram regarding total versus ionized calcium made me recall this article that was transformative for me when it was published in CHEST in December of 2015. I know that the official article was published in March 2016 but cool people like me get their hands on the manuscripts from time to time. Okay, fine, I’m not cool. CHEST sends pre-release articles out all the time. As mentioned, this article was formative for me and I hope it has the same effect for you all.
ICU practitioners, nurses, doctors, respiratory therapists are all obsessed with perfection. We want the MAP to be 65, the ABG to be perfect, and for there not to be any red numbers on the labs. What happens very often in our labs is that the calcium comes back low. Then we check an albumin and correct the calcium. Then it’s still low so we check an ionized calcium. We get that number and do whatever we choose with it. I rarely check ionized calcium in ICU patients my practice after reading this article. This is unfortunately not a free article but when there’s a will there’s a way.
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