electrolyte abnormality after thyroidectomy

Q: Which electrolyte abnormality is common after thyroidectomy?

Answer: Calcium

Most of the patients develop hypocalcemia after thyroidectomy in the first 24 hours of surgery due to associated parathyroid gland manipulation. Every patient should be monitored for hypocalcemia immediately after surgery. This can be minimized or prevented with calcium replacements 2 weeks prior to surgery. Simultaneously keeping vitamin D levels above 20 ng/mL pre-surgery helps. Checking level of serum parathyroid hormone (PTH) immediately after surgery can predict the risk of hypocalcemia. The magnitude of the drop in serum PTH is a good predictor of the risk of postoperative hypocalcemia.

 #surgical-critical-care
#endocrine
#electrolytes


References:

1. Hughes OR, Scott-Coombes DM. Hypocalcaemia following thyroidectomy for treatment of Graves' disease: implications for patient management and cost-effectiveness. J Laryngol Otol 2011; 125:849.

2. Landry CS, Grubbs EG, Hernandez M, et al. Predictable criteria for selective, rather than routine, calcium supplementation following thyroidectomy. Arch Surg 2012; 147:338. 

3. Noordzij JP, Lee SL, Bernet VJ, et al. Early prediction of hypocalcemia after thyroidectomy using parathyroid hormone: an analysis of pooled individual patient data from nine observational studies. J Am Coll Surg 2007; 205:748.