Description:
<jats:title>Abstract</jats:title><jats:p>We sought to optimize direct intravenous infusion of calcium gluconate (CaGlu) for maintaining plasma ionized calcium concentration ([Ca<jats:sup>2+</jats:sup>]) 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<jats:sup>2+</jats:sup>] was monitored at intervals of 20 to 30 minutes. At 1 g/h of CaGlu, plasma [Ca<jats:sup>2+</jats:sup>] fell by 8.35% after 40 to 50 minutes and then plateaued. At 1.6 g/h of CaGlu, plasma [Ca<jats:sup>2+</jats:sup>] fell by 6% after 20 to 30 minutes and then plateaued. The difference at 40 to 50 minutes was significant (<jats:italic>P</jats:italic> = .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 (<jats:italic>P</jats:italic> = .044). CaGlu at 1.6 g/h stabilized plasma [Ca<jats:sup>2+</jats:sup>] and appears to prevent hypocalcemic reactions during TPE.</jats:p>