Abstract
Ca++, CaTot, Mg, PO4 protein, pH and iPTH were measured in 16 1-6 day old hyperbilirubinemic infants before and during exchange transfusions with CPD blood. 9 of the 16 infants were supplemented with 0.11 mmoles iv Ca-gluconate after every 100 ml (20-30 min.) exchanged blood. Basal levels were: Ca++ 2.15-4.41 mg/dl (adult range 4.07-5.21), CaTot 6.1-10.3 ml/dl (8.9-10.2), PO4 4.1-10.0 mg/dl, and iPTH 16-102 ng/ml (<40). After 30 ml (7.3±0.6 min.) exchanged blood, Ca++ decreased by 6.9% (paired t test p<0.001), Q-oT increased by 8.5% (p<0.01) and iPTH by 26.8% (p<0.02). After 90 ml (20.0±1.5 min.) Ca Tot increased by 3.1% (p<0.01) and PO4 by 21.7% (p<0.001). At the end of the exchange, Ca++ decreased by 19.2% (p<0.001) and CaTot increased by 20.4% (p 0.001), Q-oT by 11.6% (p<0.001) and PO4 by 35.8% (p<0.001), whereas iPTH returned to basal levels, iv Ca-supplementation resulted in an increase of CaTot, but not in Ca++, Q-oT decreased by up to 10% for less than 1 min. Mg, proteins and pH remained unchanged.
In conclusion, Ca++ is decreased and iPTH increased in 1-6 day old infants in relation to the normal adult range. Exchange transfusions with CPD blood resulted in a decrease in Ca++ with a. Q-oT-prolongation and an increase in iPTH and CaTot. iv supplementation with Ca is ineffective, since it is bound within seconds.
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Wieland, P., Fischer, J., Binswanger, U. et al. 130: Ionised calcium (Ca++), total calcium (CaTot) and immunoreactive parathyroid hormone (iPTH) and electrocardiographic changes with CPD blood before and during exchange transfusions. Pediatr Res 10, 892 (1976). https://doi.org/10.1203/00006450-197610000-00121
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DOI: https://doi.org/10.1203/00006450-197610000-00121