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[The concentration of calcium and its fractions during heart surgery using extracorporeal circulation]
Insights
Calcium disturbances during cardiopulmonary bypass are linked to hemodilution solutions like gelatinol. Monitoring ionized calcium (Ca2+) is crucial for effective calcium homeostasis management.
Area of Science:
- Cardiovascular Surgery
- Biochemistry
- Medical Technology
Context:
- Standard bypass techniques can disrupt calcium homeostasis.
- Hemodilution solutions, particularly gelatinol, are implicated in these disturbances.
- 115 patients undergoing cardiopulmonary bypass were studied.
Purpose:
- To investigate calcium homeostasis changes during cardiopulmonary bypass.
- To identify the causes of calcium disturbances.
- To evaluate methods for controlling calcium levels.
Summary:
- Calcium homeostasis disturbances were observed in patients undergoing cardiopulmonary bypass.
- Unbalanced calcium content in hemodilution solutions, primarily gelatinol, was identified as the cause.
- Reducing gelatinol volume to 450-600 ml mitigated hypercalcemia.
- Ionized calcium (Ca2+) measurement is optimal for managing calcium levels due to influencing factors like pH, pCO2, and protein binding.
Impact:
- Findings suggest adjusting hemodilution protocols to prevent hypercalcemia.
- Highlights the importance of monitoring ionized calcium (Ca2+) for patient safety.
- Provides evidence for optimizing fluid management during cardiopulmonary bypass.
Abstract:
Changes in the concentration of calcium and its fractions have been studied in 115 patients subject to standard bypass techniques. It has been found that calcium homeostasis disturbances do really develop and are caused by the use of solutions that are not balanced with blood in their calcium content. The main source of calcium in hemodiluents was gelatinol. A decrease in gelatinol volume to 450-600 ml prevented the onset of marked hypercalcemia. As ionized calcium (Ca2+) concentration is determined not only by the total Ca level, but also by the shifts in the degree of pH- and pCO2-dependent ionization and binding and in ligand and protein content, Ca2+ determination is considered an optimal method of calcium homeostasis control during cardiopulmonary bypass.