ArticleCureus2024
Pamidronate for Hypercalcemia in Critically Ill Surgical Patients.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionHypercalcemia in critically ill patients is associated with an increased severity of illness and mortality that becomes worse as the levels rise. Pamidronate was evaluated for the treatment of hypercalcemia in critically ill surgical patients.
methodsThis retrospective study evaluated 30 critically ill surgical patients who developed hypercalcemia (ionized calcium (iCa)≥1.25 mmol/L) while in the surgical ICUs over three years. Patients were case-matched 1:1 for age and severity of illness.
resultsIn the 30 patients with an overall Acute Physiology and Chronic Health Evaluation (APACHE) II of 22±9, mechanical ventilation was required in 27/30 (90%) and hemodialysis in 11/30 (37%). Within four days of pamidronate, iCa declined from a mean of 1.46±0.14 to 1.15±0.14 mmol/L, p=0.004; however, the blood urea nitrogen (BUN) and serum creatinine (SCr) increased significantly in patients with renal impairment. An iCa≥1.35 mmol/L increased mortality from 0% to 26%.
conclusionsHypercalcemia in critically ill surgical patients is associated with increased severity of illness. Over a period of four days, pamidronate reduced iCa levels at ~0.08 mmol/L/day and corrected 80% of the hypercalcemic patients; however, it may cause further renal dysfunction.
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