2026/06/01 by Andy Kwok, Chris J Selman, Kellie Gumm +3 · 1 voice
Medicine · #Cardiac Arrest and Resuscitation #Hemodynamic Monitoring and Therapy #Trauma, Hemostasis, Coagulopathy, Resuscitation
paper · doi:10.1111/1742-6723.70300
openalex publication_date 2026/06/01 · openalex created_date 2026/06/13 · openalex updated_date 2026/07/28
OBJECTIVE: Hypocalcaemia is a common electrolyte disturbance in major trauma patients, particularly those with haemorrhagic shock. Trauma patients are often intubated as part of their care, which can result in post-induction hypotension. We aimed to estimate the effect of hypocalcaemia on post-induction hypotension. METHODS: We conducted a retrospective observational study of trauma patients ≥ 18 years old intubated in a tertiary Australian Emergency Department between 1st January 2020 and 30th September 2024. Epidemiological and clinical management data were extracted to estimate the effect of hypocalcaemia on outcomes. RESULTS: Of 478 eligible patients, 151 had available haemodynamic and calcium measurements. Post-induction hypotension occurred in 38/47 (81%) of hypocalcaemic and 69/104 (66%) of non-hypocalcaemic patients. Hypocalcaemia was associated with higher odds of post-induction hypotension (adjusted odds ratio [aOR] 2.15, 95% confidence interval [CI] 0.84-5.51), with considerable uncertainty in this estimate. Hypocalcaemic patients were more likely to receive red blood cells within 15-min post-induction (OR 2.13, 95% CI 1.12-4.04). Minimal differences were observed in cardiac arrest 15-min post-induction (OR 0.65, 95% CI 0.07-5.73) or mortality at discharge (OR 1.00, 95% CI 0.51-1.97). CONCLUSIONS: Hypocalcaemia may be associated with higher odds of post-induction hypotension in trauma patients; however, our findings require corroboration across a larger multi-centre prospective observational study. If corroborated, a randomised controlled trial is warranted to establish the utility of calcium replacement for the prevention of post-induction hypotension.