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

Autor: Zhao Y; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts.; Division of Transfusion Medicine, UMass Memorial Medical Center, Worcester, Massachusetts.; Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.; Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts., Garrity D; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Graves M; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Linden J; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., St Pierre P; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Ducharme P; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Greene M; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Vauthrin M; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Weinstein R; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts.; Division of Transfusion Medicine, UMass Memorial Medical Center, Worcester, Massachusetts.; Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.; Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts.
Jazyk: angličtina
Zdroj: Journal of clinical apheresis [J Clin Apher] 2019 Dec; Vol. 34 (6), pp. 656-660. Date of Electronic Publication: 2019 Aug 10.
DOI: 10.1002/jca.21742
Abstrakt: We sought to optimize direct intravenous infusion of calcium gluconate (CaGlu) for maintaining plasma ionized calcium concentration ([Ca 2+ ]) 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 [Ca 2+ ] was monitored at intervals of 20 to 30 minutes. At 1 g/h of CaGlu, plasma [Ca 2+ ] fell by 8.35% after 40 to 50 minutes and then plateaued. At 1.6 g/h of CaGlu, plasma [Ca 2+ ] 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 [Ca 2+ ] and appears to prevent hypocalcemic reactions during TPE.
(© 2019 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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