Optimization of infusional calcium gluconate for prevention of hypocalcemic reactions during therapeutic plasma exchange.

Abstract:

:We sought to optimize direct intravenous infusion of calcium gluconate (CaGlu) for maintaining plasma ionized calcium concentration ([Ca2+ ]) and preventing hypocalcemic reactions during 34 consecutive 1-volume therapeutic plasma exchanges (TPEs) in eight patients. CaGlu, 2 g in 50 mL of 0.9% NaCl, was prepared by our hospital pharmacy and infused at either 1.0 or 1.6 g/h during alternate TPE. Plasma [Ca2+ ] was monitored at intervals of 20 to 30 minutes. At 1 g/h of CaGlu, plasma [Ca2+ ] fell by 8.35% after 40 to 50 minutes and then plateaued. At 1.6 g/h of CaGlu, plasma [Ca2+ ] fell by 6% after 20 to 30 minutes and then plateaued. The difference at 40 to 50 minutes was significant (P = .015). Hypocalcemic reactions were noted in three patients during 5 of 17 TPE at 1.0 g/h (all after 40 to 60 minutes) but 0 of 17 TPE at 1.6 g/h (P = .044). CaGlu at 1.6 g/h stabilized plasma [Ca2+ ] and appears to prevent hypocalcemic reactions during TPE.

journal_name

J Clin Apher

authors

Zhao Y,Garrity D,Graves M,Linden J,St Pierre P,Ducharme P,Greene M,Vauthrin M,Weinstein R

doi

10.1002/jca.21742

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

656-660

issue

6

eissn

0733-2459

issn

1098-1101

journal_volume

34

pub_type

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