IBCC Episode 41 - Hypercalcemia

The podcast addresses hypercalcemia, focusing on its recognition, symptoms, and treatment in critical care settings. Symptoms range from psychiatric issues and abdominal pain to delirium and coma, with EKG findings like shortened QT intervals in acute cases. The discussion emphasizes the importance of using ionized calcium levels for accuracy, rather than uncorrected total levels. Hypercalcemia is commonly caused by hyperparathyroidism or malignancy, with malignancy being more prevalent in critical care. Treatment strategies include addressing underlying causes, volume resuscitation with pH-guided fluids (such as plasmolyte or isotonic bicarbonate), and a combination of calcitonin and bisphosphonates to reduce calcium reabsorption from bone. The hosts caution against over-reliance on forced diuresis and highlight the pitfall of delaying bisphosphonate treatment.