Biomaterial Database

Hypocalcaemia during rapid blood transfusion in anaesthetized man. 1976

J K Denlinger, and M L Nahrwold, and P S Gibbs, and J H Lecky

In anaesthetized patients, administration of citrated whole blood for 5 min at controlled rates of 50, 100 and 150 ml/70 kg/min resulted in decreases in the calcium ion concentration (Ca2+) of 14, 31 and 41%, respectively. Ca2+ returned rapidly to the control values after termination of the transfusion. Reciprocal changes in serum citrate concentrations occurred, suggesting that the transient hypocalcaemia was a result of redistribution of citrate and hepatic or renal clearance from the vascular space. The total serum calcium concentration did not change significantly during rapid blood administration. Normal saline infusion at 100 ml/70 kg/min caused no change in Ca2+; however, plasma protein administration at this rate resulted in an 18% decrease in Ca2+, presumably as a consequence of the binding of calcium ions to anionic sites on plasma protein. Hypocalcaemia accompanying blood transfusion is a transient phenomenon, dependent on the total dose of citrate administered and the rate of infusion. Rational calcium replacement therapy during massive blood transfusion may now be based on direct Ca+ measurement.

UI	MeSH Term	Description	Entries
D006996	Hypocalcemia	Reduction of the blood calcium below normal. Manifestations include hyperactive deep tendon reflexes, Chvostek's sign, muscle and abdominal cramps, and carpopedal spasm. (Dorland, 27th ed)	Hypocalcemias
D007263	Infusions, Parenteral	The administration of liquid medication, nutrient, or other fluid through some other route than the alimentary canal, usually over minutes or hours, either by gravity flow or often by infusion pumping.	Intra-Abdominal Infusions,Intraperitoneal Infusions,Parenteral Infusions,Peritoneal Infusions,Infusion, Intra-Abdominal,Infusion, Intraperitoneal,Infusion, Parenteral,Infusion, Peritoneal,Infusions, Intra-Abdominal,Infusions, Intraperitoneal,Infusions, Peritoneal,Intra Abdominal Infusions,Intra-Abdominal Infusion,Intraperitoneal Infusion,Parenteral Infusion,Peritoneal Infusion
D007668	Kidney	Body organ that filters blood for the secretion of URINE and that regulates ion concentrations.	Kidneys
D008099	Liver	A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances.	Livers
D011188	Potassium	An element in the alkali group of metals with an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte that plays a significant role in the regulation of fluid volume and maintenance of the WATER-ELECTROLYTE BALANCE.
D002118	Calcium	A basic element found in nearly all tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes.	Coagulation Factor IV,Factor IV,Blood Coagulation Factor IV,Calcium-40,Calcium 40,Factor IV, Coagulation
D002951	Citrates	Derivatives of CITRIC ACID.
D002986	Clinical Trials as Topic	Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries.	Clinical Trial as Topic
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000758	Anesthesia	A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.