Calcium Homeostasis during Sepsis

Calcium is essential for normal cellular and organ function. It is important for excitation-contraction coupling, neurotransmitter and hormonal secretion, blood coagulation, enzyme activity, cell division, and growth and repair. In addition, calcium is now recognized to be a major intracellular messenger, coupling surface receptor activation to intracellular events. Thus, calcium is important for cardiovascular, neural, and immune responses to infection. However, calcium may also be instrumental in causing cellular damage and organ failure during sepsis. Calcium may activate Upases, nucleases, and proteases which are capable of damaging cells. It is also felt to be important for the generation of prostaglandins, free radicals, and cytokines which are capable of causing cellular injury. In this chapter, we will review the current data related to calcium homeostasis during sepsis and attempt to make some recommendations for therapy based upon the available literature.