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Prophylaxis against hypocalcemia in low-birth-weight infants requiring bicarbonate infusion
Insights
Low-birth-weight infants with respiratory issues experienced declining serum calcium levels. Calcium infusion helped maintain normal levels, even with bicarbonate therapy, suggesting calcium shifts into bone.
Area of Science:
- Neonatal Medicine
- Pediatric Endocrinology
- Biochemistry
Background:
- Low-birth-weight infants often present with respiratory distress.
- Serum calcium regulation is critical in neonates, especially those with metabolic disturbances.
- Acidosis and bicarbonate therapy can impact calcium homeostasis in infants.
Purpose of the Study:
- To investigate serum calcium concentrations and urinary calcium excretion in low-birth-weight infants with respiratory distress.
- To evaluate the effect of calcium infusion on serum calcium levels in these infants.
- To explore the relationship between calcium metabolism, bicarbonate therapy, and acidosis.
Main Methods:
- Studied 48 low-birth-weight infants with varying degrees of respiratory distress.
- Monitored serum calcium concentration and urinary calcium excretion over 24 hours.
- Administered continuous calcium infusion (1 mg/kg/hr) to a subset of infants.
Main Results:
- Serum calcium decreased significantly over 24 hours in infants not receiving calcium infusion.
- The decline in serum calcium was more pronounced in infants receiving bicarbonate for acidosis.
- Continuous calcium infusion maintained relatively normal serum calcium levels, irrespective of bicarbonate use.
Conclusions:
- Calcium infusion is effective in stabilizing serum calcium in low-birth-weight infants with respiratory distress and acidosis.
- Urinary calcium excretion does not fully explain the observed changes in extracellular calcium.
- A shift of calcium into bone is a potential mechanism influencing calcium levels in these infants.
Abstract:
Forty-eight low-birth-weight infants with varying degrees of respiratory distress were studied with respect to serum calcium concentration and urinary calcium excretion. Serum calcium decreased over the 24-hour study period in infants who did not receive calcium infusion. The decrease was greater in those receiving bicarbonate therapy for acidosis. Continuous calcium infusion at 1 mg/kg/hr sustained relatively normal serum calcium concentration, even in those infants who required bicarbonate. Since the changes in estimated extracellular calcium could not be accounted for by urinary excretion, a shift of calcium into bone was postulated.