Hypocalcemia in the polytraumatized patient: A systematic review

Abstract text (incl. references and figure legends)

Introduction: Trauma-induced hypocalcemia is a severe complication, in view of the importance of calcium in the regulation of the body's physiological mechanisms. For this reason, the negative hemodynamic effects of hypocalcemia must be managed early in polytrauma patients, as they are linked to the lethal diamond: hypothermia, acidosis, coagulopathy and hypocalcemia. Thus, the objective of this article is to review about hypocalcemia in polytraumatized patients, with emphasis on the repercussion of this condition. Methods: A systematic review was performed by searching scientific articles – reviews, systematic reviews and meta-analysis -, published in the last five years in PubMed. The keywords used were "hypocalcemia" and "trauma" with the Boolean operator "AND". In total, 44 articles were found, but only 3 were selected, considering the title and the abstract reading. Results: Polytrauma patients often present with hypocalcemia in the setting of severe hemorrhage secondary to trauma, which can be exacerbated by the need for transfusion and resuscitation. Thus, the time between trauma and treatment of the resulting massive bleeding should be as short as possible, using techniques for fast bleeding control and avoiding aggravating factors, such as hypocalcemia. Conclusions: Hypocalcemia is associated with increased morbimortality in trauma patients. Therefore, fast and effective management of these patients is fundamental. References: Wray JP, et al. The diamond of death: Hypocalcemia in trauma and resuscitation. Am J Emerg Med. 2021 Mar; 41:104-109. doi: 10.1016/j.ajem.2020.12.065. Epub 2020 Dec 28. PMID: 33421674.; DeBot M, et al. Trauma-induced hypocalcemia. Transfusion. 2022 Aug;62 Suppl 1:S274-S280. doi: 10.1111/trf.16959. Epub 2022 Jun 24. PMID: 35748689.; Vasudeva M, et al. Hypocalcemia in trauma patients: A systematic review. J Trauma Acute Care Surg. 2021 Feb 1;90(2):396-402. doi: 10.1097/TA.0000000000003027. PMID: 33196630; PMCID: PMC

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