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DRG Category: 640
Mean LOS: 5.1 days
Description MEDICAL: Nutritional and Miscellaneous Metabolic Disorders with Major CC
Hypocalcemia is a diminished calcium level, below 8.5 mg/dL, in the bloodstream. Calcium is vital to the body for the formation of bones and teeth, blood coagulation, nerve impulse transmission, cell permeability, and normal muscle contraction. Although nearly all of the body's calcium is found in the bones, three forms of calcium exist in the serum: free or ionized calcium, calcium bound to protein, and calcium complexed with citrate or other organic ions. Ionized calcium is reabsorbed into bone, absorbed from the gastrointestinal mucosa, and excreted in urine and feces as regulated by the parathyroid glands. Parathyroid hormone is necessary for calcium absorption and normal serum calcium levels.
Hypocalcemia is a more common clinical problem than hypercalcemia and may occur as frequently as 15% to 50% in acutely and critically ill patients. When calcium levels drop, neuromuscular excitability occurs in smooth, skeletal, and cardiac muscle, causing the muscles to twitch. The result can lead to cardiac dysrhythmias. Hypocalcemia can also cause increased capillary permeability, pathological fractures, and decreased blood coagulation. Most severe cases result in tetany (condition of prolonged, painful spasms of the voluntary muscles of the fingers and toes [carpopedal spasm] as well as the facial muscles), which, if left untreated, leads to carpopedal and laryngeal spasm, seizures, and respiratory arrest.