Detection of Hypocalcemia in Susceptible Neonates

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Abstract
The reliability of electrocardiographic detection of neonatal hypocalcemia was assessed in 36 full-term and 44 premature infants. The corrected Q-T interval (Q-Tc) correlated with total (r = -0.34, p<0.05) and ionized calcium (r = -0.51, p<0.01) in full-term but not in premature infants. In contrast, the corrected Q-oT interval (Q-oTc) improved the correlation with the total (r = -0.60, p<0.01) and ionized calcium (r = -0.66, p<0.001) in full-term infants, and also correlated with total (r = -0.49, p<0.01) and ionized calcium (r = -0.59, p<0.001) in premature infants. Ionized calcium was low in 70 per cent of cases when the Q-oTc interval was prolonged, and in only 2 per cent when the Q-oTc interval was normal. Hypocalcemia developed in 20 of 33 neonates with asphyxia, shock, acidosis, respiratory distress or maternal diabetes, but not in 47 infants without these complications, regardless of the gestational age. The Q-oTc interval permits rapid reliable screening for hypocalcemia in these high-risk neonates. (N Engl J Med 290:931–935, 1974)