Time to stop debating about the everlasting story: Some issues concerning serum total calcium and ionized calcium

摘要

: We appreciate the interesting and attentive article titled “Predictive accuracy of serum total calcium for both critically high and critically low ionized calcium in critical illness,” written by Hu . The use of serum total calcium and its corrected value in predicting critical ionized calcium concentration in critical illness is controversial. Hence, the authors retrospectively searched the Medical Information for Intensive Care III database to determine whether the level of total calcium, either corrected for albumin or not, could predict critically high and low ionized calcium. The authors concluded that both uncorrected and corrected total calcium levels are unreliable indexes for predicting the critical values of ionized calcium in critical illness. It is fully believed that this article will provide a profound presentation of and supplement to the everlasting story of calcium state estimation by total calcium. To completely understand the story between total calcium and ionized calcium and comprehensively interpret the results regarding calcium in this manuscript, some issues should first be prioritized.