The Role of Intraoperative Rapid Parathyroid Hormone Monitoring for Predicting Thyroidectomy-Related Hypocalcemia

Abstract

Objective:To determine if the intraoperative rapid parathyroid hormone (PTH) assay can be used to accurately predict postoperative calcium levels following total or completion thyroidectomy.Design: A prospective study.Setting: Tertiary care referral center. Patients:One hundred four patients following a total or completion thyroidectomy.Intervention: Intraoperative rapid plasma PTH levels were determined for patients undergoing a total or completion thyroidectomy. Main Outcome Measures:Parathyroid hormone levels were recorded after the induction of anesthesia, before excision, and 5, 10, and 20 minutes after thyroidectomy. Postoperative calcium levels were monitored every 6 hours until hospital discharge. Intraoperative PTH levels were correlated with postoperative calcium levels and clinical symptoms of hypocalcemia.Results: Twenty-two patients (21.2%) required short-

Parathyroid Hormone Assay Predicts Hypocalcaemia After Total Thyroidectomy

“…This study indicates that a single postoperative measurement of intact PTH is a reliable way of predicting which patients are likely to develop postoperative hypocalcaemia after TT. These findings support the work of other groups that have used PTH measurement to identify hypoparathyroidism 8–12 …”

Kinetics of serum parathyroid hormone during and after thyroid surgery

“…In the present study, six (1·5 per cent) of 402 patients developed persistent hypoparathyroidism. Transient symptomatic hypocalcaemia was observed in 61 (15·2 per cent) of 402 patients, comparable to the incidence in other studies (up to 25 per cent)13, 16, 17.…”

Influence of magnesium sulphate infusion before total thyroidectomy on transient hypocalcemia — a randomised study

“…In our study, the rate of the patients with laboratory transient hypocalcemia (27%) and those with clinically transient hypocalcemia (23%) was in the interval of 6.2-68%, which was simi-lar to that reported in the literature. 2,3,14,[22][23][24][25][26] In the study by Wilson et al, in which the definitions of laboratory and clinical hypocalcemia are similar to the definitions in our study, 68% of patients were diagnosed with laboratory transient hypocalcemia and 36% of patients had symptoms of hypocalcemia. 3 They defined hypomagnesemia as serum concentration of magnesium lower than 0.7 mmol/L and the same definition was used in our study.…”