Hypoparathyroidism |

Hypoparathyroidism

Thu, 12/27/2007 - 00:00 — oxygen

Hypoparathyroidism Listen to Audio

clinical causes clinical manifestations diagnosis treatment anesthetic management Clinical causes: -MCC parathyroidectomy Clinical manifestations: (primarily from decreased Ca2+) CNS: dementia, depression, psychosis CVS: hypotension, ECG changes (prolonged QT interval), CHF NMJ: muscle weakness Diagnosis: -decreased [Ca2+] Primary hypoparathyroidism: -decreased PTH -decreased [Ca2+] Treatment: Initial dose: -Calcium Chloride 10% 3-5 ml which provides 272 mg Ca2+ -Calcium Gluconate 10% 10-20 ml which provides 93 mg Ca2+ subsequent doses: -either repeat bolus as needed -or continuous infusion 1-2mg/kg/hr Anesthetic management: CVS: decreased [Ca2+] may lead to: -hypotension: therefore avoid cardiodepressant anesthetics -ecg changes: prolonged QT interval. Avoid citrate products (ex. blood) -heart failure Resp: -avoid respiratory alkalosis -hyperventilation will worsen preexisting hypocalcemia Fluids/Electrolyes: -avoid 5% albumin solution -further reduces [Ca2+]

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