Predictors of hypocalcemia occurring after a total/near total thyroidectomy

Kara, Muammer; Tellioglu, Gurkan; Krand, Osman; Fersahoglu, Tuba; Berber, İbrahim; Erdoğdu, Erdal; Özel, Leyla; Titiz, M.I.

doi:10.1007/s00595-009-3957-1

Cited by 24 publications

(29 citation statements)

References 22 publications

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“…Some investigators have proposed serial measurements of calcium (6, 12, and 20 h or 8, 14, and 20 h) as a protocol for monitoring postthyroidectomy patients (16)(17)(18)(19). Others (7-9) have suggested combining intact parathyroid hormone (PTH) and serum calcium measurements.…”

Section: Discussionmentioning

confidence: 99%

Is ionized calcium a reliable predictor of hypocalcemia after total thyroidectomy? A before and after study

Tartaglia

Giuliani

Sgueglia

et al. 2014

gchir

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Hypocalcemia may be the only complication precluding a short postoperative hospital stay after total thyroidectomy (1, 2). Much has been written in the literature about the possibility of identifying (using different methods and predictors) which thyroidectomy patients will develop symptomatic hypocalcemia and which will not. Some authors (3-6) consider early postoperative (24-hour) serum calcium levels and intraoperative identification of parathyroid glands to be important predictive factors. Others (7-9) have instead suggested combining intact parathyroid hormone (PTH) and serum calcium measurements, arguing that PTH and serum calcium monitoring after the first postoperative hour would allow reliable prediction of postoperative hypocalcemia. Some authors (10-12) recommend quick PTH assay as a means of predicting postoperative parathyroid function, although others (13) found no overall significant difference in the capacity of intraoperative PTH levels, versus early postoperative serum calcium levels (day 1), to predict long-term hypoparathyroidism. In an attempt to identify reliable predictors of post-operative hypocalcemia, we measured ionized calcium levels before and after surgery and compared the data gathered with total serum calcium levels and symptoms of hypocalcemia (paresthesias and Chvostek's sign). The aim of the present study was to determine whether ionized calcium concentration is a better predictor of post-thyroidectomy hypocalcemia than total serum calcium.

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Section: Discussionmentioning

confidence: 99%

Is ionized calcium a reliable predictor of hypocalcemia after total thyroidectomy? A before and after study

Tartaglia

Giuliani

Sgueglia

et al. 2014

gchir

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“…1,[8][9][10][11][12] A surgeon needs to know whether the parathyroid glands are at risk during surgery, because persistent hypoparathyroidism is a harrowing condition. A stable or increased intraoperative PTH concentration rules out the possibility of persistent hypoparathyroidism.…”

Section: Discussionmentioning

confidence: 99%

“…Kara et al reported that 54% of patients who underwent either a total or near total thyroidectomy develop transient hypocalcemia. 1 Hypocalcemia is self-limiting in most patients and does not require treatment; however, symptomatic hypocalcemia is of particular concern. Symptoms usually manifest 24 to 48 h after the operation, and it is not usually easy to predict which patients are prone to the development of this complication and will require calcium and/or vitamin D supplements.…”

Section: Introductionmentioning

confidence: 99%

Is routine calcium supplementation necessary in patients undergoing total thyroidectomy plus neck dissection?

Gao

2011

Surg Today

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“…Das intraoperative Monitieren der Funktion des N. laryngeus recurrens kann dieses Trauma nicht minimieren. Postoperativ kann die Kompression durch ein lokales Hämatom ursäch-lich sein [7,8,9,10].…”

Section: Ursachenunclassified

Vermeidung und Management des Hypoparathyreoidismus nach Schilddrüsenoperationen

Selberherr

Niederle

2014

Chirurg

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Postoperative hypoparathyroidism after bilateral thyroid gland surgery or after interventions for recurrence is defined as intact parathyroid hormone levels (iPTH) < 15 pg/ml with simultaneous normal, below normal and markedly decreased serum calcium levels. After bilateral thyroid surgery and after reoperations a single iPTH measurement performed 12-24 h postoperatively can be used to predict parathyroid metabolism. Patients with an iPTH level ≥ 15 pg/ml may be discharged safely, patients with an iPTH < 10 pg/ml must be substituted with calcium and vitamin D and patients with an iPTH between 10 and 15 pg/ml (grey zone) may be discharged if a second measurement 48 h after surgery documents an iPTH ≥ 15 pg/ml. This procedure increases the length of hospital stay. Patients in the (grey zone) must be substituted. The iPTH level and its course determine the necessity, dose and length of calcium and vitamin D substitution.

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Predictors of hypocalcemia occurring after a total/near total thyroidectomy

Abstract: Intact parathormone measurement 10 min after SC is helpful to predict early postoperative hypocalcemia. An IPTH decrease >/=30% at this time point estimates the risk of postoperative hypocalcemia.

Cited by 24 publications

References 22 publications

Is ionized calcium a reliable predictor of hypocalcemia after total thyroidectomy? A before and after study

Is ionized calcium a reliable predictor of hypocalcemia after total thyroidectomy? A before and after study

Is routine calcium supplementation necessary in patients undergoing total thyroidectomy plus neck dissection?

Vermeidung und Management des Hypoparathyreoidismus nach Schilddrüsenoperationen

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