| Treatment of medically refractory hypercalcemic crisis. | |
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MedLine Citation:
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PMID: 22476881 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Case: A 58-year-old patient was admitted to the intensive care unit for severe hypercalcemia (total Ca 5.30 mmol/L) complicated with status epilepticus, hypertensive crisis and acute renal failure. Renal replacement therapy was explored as a method for treating medically refractory hypercalcemia. Methods: Because of hemodynamic instability during intermittent hemodialysis (IHD), continuous venovenous hemofiltration (CVVH) with high rates of calcium-free replacement fluids was instituted. Epoprostenol rather than citrate was used as anticoagulation to ensure adequate extracorporeal anticoagulation. Results: CVVH was continued for 40 hours total during which ionized calcium decreased from 2.19 to 1.07 mmol/L. The etiology of the hypercalcemia was from autoinfarction of a parathyroid adenoma. Conclusions: This is the first case of hypercalcemia treated with CVVH with epoprostenol anticoagulation. This method avoids some of the pitfalls of using intermittent hemodialysis. It is also a rare example of hypercalcemia induced posterior reversible encephalopathy syndrome (PRES). |
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Authors:
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Selena Au; Michael Dunham; Tomas Godinez |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-4-5 |
Journal Detail:
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Title: The International journal of artificial organs Volume: - ISSN: 1724-6040 ISO Abbreviation: - Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-4-5 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802649 Medline TA: Int J Artif Organs Country: - |
Other Details:
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Languages: ENG Pagination: 0 Citation Subset: - |
Affiliation:
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Department of Critical Care Medicine, University of Calgary, Alberta - Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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