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Related Experiment Videos

Calcium: limited indications, some danger.

B M Thompson, H S Steuven, D J Tonsfeldt

    Circulation
    |December 1, 1986
    PubMed
    Summary
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    Calcium chloride is not proven to improve survival for cardiac arrest patients with asystole or electromechanical dissociation (EMD). While it may improve resuscitation rates in EMD, long-term survival remains poor, questioning its routine use.

    Area of Science:

    • Cardiology
    • Emergency Medicine
    • Clinical Pharmacology

    Background:

    • Calcium chloride has been historically used for cardiac resuscitation since the 1920s.
    • Concerns exist regarding side effects and dangerously elevated serum calcium levels with recommended dosages.
    • Previous studies have yielded conflicting results on its efficacy.

    Purpose of the Study:

    • To evaluate the effectiveness of calcium chloride in improving survival rates for patients with asystole and electromechanical dissociation (EMD).
    • To assess the safety and efficacy of calcium chloride administration during cardiopulmonary resuscitation (CPR).

    Main Methods:

    • A prospective, randomized, double-blind study comparing calcium chloride versus saline placebo in a paramedic system.
    • Analysis of resuscitation rates and long-term survival in patients experiencing asystole and EMD.

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  • Review of existing retrospective clinical studies and case reports.

    • Main Results:

    • No statistically significant difference in resuscitation or long-term survival was observed for asystole patients treated with calcium chloride versus placebo.
    • Patients with EMD showed improved resuscitation rates with calcium chloride, but only one survived to hospital discharge.
    • Studies indicate that recommended dosages can lead to dangerously high serum calcium levels.

    Conclusions:

    • Routine use of calcium chloride in asystole and EMD is not supported by current evidence due to lack of demonstrated benefit.
    • Further large-scale multicenter trials are needed to definitively prove or disprove its efficacy in these cardiac arrest rhythms.
    • Calcium administration remains indicated for patients with confirmed or suspected hypocalcemia or hyperkalemia.