Prophylactic infusion of calcium gluconate to prevent a symptomatic fall in plasma ionized calcium during therapeutic plasma exchange: A comparison of two methods
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Media type:
E-Article
Title:
Prophylactic infusion of calcium gluconate to prevent a symptomatic fall in plasma ionized calcium during therapeutic plasma exchange: A comparison of two methods
Published in:
Journal of Clinical Apheresis, 33 (2018) 5, Seite 600-603
Language:
English
DOI:
10.1002/jca.21648
ISSN:
1098-1101;
0733-2459
Origination:
Footnote:
Description:
AbstractWe compared two methods of calcium gluconate infusion to maintain plasma ionized calcium ([Ca2+]) during therapeutic plasma exchange (TPE) performed using the Spectra Optia Apheresis System. Method A, our legacy method, consisted of adding 5 mL of 10% calcium gluconate to each 500 mL bottle of 5% albumin replacement fluid. Method B used an accessory IV infusion of calcium gluconate (2 g in 50 mL of 0.9% NaCl starting at 25 mL/h). Plasma [Ca2+] was measured at 20‐minute intervals, and symptoms of hypocalcemia were recorded during TPE. Baseline [Ca2+] was the same (P = 0.616), as was total acid citrate dextrose Formula A used (P = 0.865), with either method. TPE with method A used 2.62 ± 0.52 g of calcium gluconate vs 1.13 ± 0.27 g with method B (P < 0.001). [Ca2+] remained stable with method A (P = 0.251), but fell on average by 5% with method B (P < 0.05). Hypocalcemic symptoms were reported in 0 of 23 TPE with method A and 2 of 24 TPE with method B. We conclude that both methods A and B prevent a symptomatic fall in plasma [Ca2+] during TPE. Method B requires significantly less calcium gluconate than does method A.