Estimation of ionized calcium levels after thyroidectomy at King Abdul Aziz University Hospital (Jeddah)
Aim: To determine the incidence of hypocalcaemia and the need for calcium supplementation after thyroid surgery in 120 patients.
Methods: A prospective study to determine the incidence of hypocalcaemia by measuring ionized calcium level in 120 patients underwent thyroidectomy at King Abdul Aziz University Hospital, the data included pre- and post-operative ionized calcium level, albumin, free thyroxine, thyrotopin and alkaline phosphatase. As well include age, gender, type of thyroidectomy and pathological characteristics of resected thyroid tissue and aoutotransplantion of parathyroid gland. Treatment of post-operative hypocalcaemia and duration of treatment was recorded.
Results: Hypocalcaemia occurred in (15%) 18 patients from total of 120 patients who underwent total thyroidectomy, had a significant lower calcium level of 1.78±0.054 mmol/l compared to 102 (85%) patients with normal calcium level. Sixteen patients required calcium supplementation with or without oral vitamin D3. Three patients developed hypoparathyroidism with PTH level of 23 pg/l. Two patients developed laryngeal stridor and were treated initially by i.v. infusion of calcium gluconate.
Conclusion: Measuring or calculating ionized calcium level post thyroidectom, to avoid unnecessary calcium supplementation resulting from diagnosing hypocalcaemia from measuring total calcium level alone is more accurate and more appropriate.