Trauma‐induced hypocalcemia. (24th June 2022)

• Record Type: Journal Article
• Authors: DeBot, Margot; Sauaia, Angela; Schaid, Terry; Moore, Ernest E.
• Other Names: Yazer Mark H. guestEditor.; Watts Sarah A. guestEditor.; Woolley Col Tom guestEditor.
• Is Part Of: Transfusion. Volume 62(2022)Supplement 1
• Page Start: S274
• Page End: S280
• Publication Date: 2022-06-24
• Subjects: calcium supplementation -- coagulopathy -- death diamond -- endotheliopathy of trauma -- hemorrhagic shock -- hemostasis -- hypocalcemia -- resuscitation -- transfusion complications -- transfusion practices -- trauma; Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.16959
• Languages: English
• ISSNs: 0041-1132

Abstract

Abstract: Background: Trauma‐induced hypocalcemia is an underappreciated complication of severe injury but is well known to result in the derangement of an array of physiological regulatory mechanisms. Existing literature provides a compelling link between hypocalcemia and worse trauma‐induced coagulopathy and increased mortality after injury. Study Design and Methods: This narrative review evaluates available data related to the risk factors, mechanisms, and treatment of hypocalcemia after severe injury. The authors did not perform a systemic review or meta‐analysis. Results and Discussion: The interplay of acidosis, hypothermia, and coagulopathy with hypocalcemia potentiates the bloody vicious cycle of hemorrhagic shock which has been the paradigm of trauma resuscitation for over half a century. However, current screening and treatment of postinjury hypocalcemia are relegated to a secondary consideration in trauma resuscitation. We conclude calcium supplementation should be a primary tier intervention for life‐threatening injury.