The cardiopulmonary effects of calcium infusion in infants with persistent pulmonary hypertension of the newborn.
Low blood ionized calcium levels have been reported previously in association with alkalosis in infants undergoing hyperventilation for persistent pulmonary hypertension. We investigated the effect of acute calcium infusions on the cardiopulmonary status of 10 hypocalcemic, hyperventilated infants with persistent pulmonary hypertension. Acid-base status, arterial partial pressure of oxygen, vital signs, and echocardiographically determined right and left systolic time interval ratios and left ventricular shortening fractions were obtained before and after rapid infusions of calcium gluconate or saline. At 5 and 15 min after calcium infusion, but not after saline infusion, there were significant decreases in both right and left ventricular systolic time interval ratios, and an increase in transcutaneous PO2 and PaO2 that coincided with peak levels of ionized calcium. These findings provide evidence that high levels of ionized calcium in newborns with persistent pulmonary hypertension transiently improve myocardial performance and oxygenation.
Bifano
E
E
State University of New York, Health Science Center, Syracuse 13210.
Kavey
R E
RE
Pergolizzi
J
J
Slagle
T
T
Bergstrom
W
W
D001785:Blood Gas Monitoring, Transcutaneous; D002118:Calcium / Q000097:blood*; D002125:Calcium Gluconate / Q000008:administration & dosage / Q000494:pharmacology*; D004452:Echocardiography; D005260:Female; D005942:Gluconates / Q000494:pharmacology*; D006801:Humans; D007231:Infant, Newborn; D007261:Infusions, Intra-Arterial; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects*; D010547:Persistent Fetal Circulation Syndrome / Q000097:blood / Q000378:metabolism / Q000503:physiopathology*; D010758:Phosphorus / Q000097:blood; D013599:Systole / Q000187:drug effects*; D014469:Umbilical Arteries
D005942:Gluconates; D010758:Phosphorus; D002125:Calcium Gluconate; D002118:Calcium