Calcium chloride administration in normocalcemic critically ill patients.
Ten normocalcemic critically ill patients who had experienced a decrease in cardiac index greater than or equal to 0.5 liter/min/m2 after incremental changes of PEEP received 7 mg/kg of CaCl2 as a slow iv bolus, followed by an infusion of 20 mg/kg CaCl2 over 60 min. Hemodynamic pressures and flow, oxygen uptake and transport, and blood chemistry variables were determined over a 120-min period. The results indicated that: (1) hemodynamic variables were not affected except for left ventricular stroke work index and mean blood pressure, which increased slightly; (2) both serum calcium and ionized calcium concentrations increased significantly, sometimes to dangerous levels; (3) colloid osmotic pressure and hemoglobin levels decreased slightly but consistently. In conclusion, CaCl2 administration failed to improve hemodynamic function depressed by PEEP. If CaCl2 can play a relevant role in the management of cardiovascular depression, further identification of appropriate doses and patients is necessary.
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002118:Calcium / Q000097:blood; D002122:Calcium Chloride / Q000008:administration & dosage*; D002302:Cardiac Output; D003422:Critical Care; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006454:Hemoglobins; D006801:Humans; D008875:Middle Aged; D010101:Oxygen Consumption; D011175:Positive-Pressure Respiration
D006454:Hemoglobins; D002122:Calcium Chloride; D002118:Calcium