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Calcium Chloride Infusions are Not Associated with Improved Outcomes in Neonates Undergoing Cardiac Operations

Laura E Murray1, Holly Burchett1, Shahryar M Chowdhury1

  • 1Department of Pediatrics, Medical University of South Carolina, 10 McClennan Banks Drive, Charleston, SC, 29425, USA.

Pediatric Cardiology
|September 15, 2021
PubMed

Insights

Postoperative calcium chloride infusions did not improve cardiac performance in neonates after heart surgery. This study found no reduction in the need for other medications or improved patient outcomes.

Area of Science:

  • Cardiology
  • Neonatal Medicine
  • Pediatric Surgery

Background:

  • Neonatal cardiac function relies on myocardial calcium. Limited data exists on calcium chloride infusions in neonates undergoing cardiac surgery.
  • Calcium's role in supporting cardiac output in this population requires further investigation.

Purpose of the Study:

  • To determine if postoperative calcium chloride infusions reduce the need for inotropic and vasoactive medications in neonates after cardiac surgery.
  • To evaluate the impact of calcium chloride on cardiac output and patient outcomes in this cohort.

Main Methods:

  • Retrospective cohort study of neonates (≤30 days old) undergoing cardiac surgery between 06/2015 and 12/2018.
  • Patients were divided into groups receiving (calcium group) or not receiving (control group) postoperative calcium chloride infusions.
  • Primary outcome: maximum Vasoactive Inotropic Score (VIS) > 15 within 24 hours post-surgery.

Main Results:

  • No significant difference in maximum VIS > 15 between the calcium group (70%) and control group (55%; p=0.08).
  • Similar outcomes observed between groups regarding ventilation duration, enteral feeding time, hospital length of stay, and operative mortality.
  • Calcium chloride infusions did not decrease exposure to other vasoactive agents or improve outcomes.

Conclusions:

  • Postoperative calcium chloride infusions did not reduce the requirement for inotropic/vasoactive agents in neonates following cardiac surgery.
  • The use of calcium chloride infusions did not demonstrate improved clinical outcomes in this patient population.
  • Further research may be needed to clarify the role, if any, of calcium chloride in neonatal cardiac surgery care.

Keywords:
CalciumCongenital heart diseaseCongenital heart surgeryIntensive careNeonateOutcomes

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