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The effect of calcium gluconate administration during cardiopulmonary bypass on hemodynamic variables in infants
Seyedeh Zahra Faritous1, Saeed Rajabzade Zaree1, Zohreh Morshedizad2
1Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali_e_Asr St., Tehran, Iran.
Insights
Calcium gluconate administration during cardiopulmonary bypass in infants undergoing open-heart surgery significantly altered hemodynamic variables, including blood pressure and heart rate. This intervention impacts metabolic balance and clinical outcomes in pediatric cardiac surgery patients.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Anesthesiology
Background:
- Complications after heart surgery significantly impact patient outcomes and healthcare costs.
- Maintaining metabolic balance, including hormones and electrolytes like calcium, is crucial for cardiac function.
- Pediatric patients undergoing heart surgery are susceptible to calcium depletion.
Purpose of the Study:
- To evaluate the effect of calcium gluconate administration during cardiopulmonary bypass on hemodynamic variables and clinical outcomes.
- To assess the impact of calcium supplementation on infants undergoing open-heart surgery.
Main Methods:
- A controlled randomized clinical trial involving 60 infants undergoing open-heart surgery (weight ≤10 kg).
- Intervention group received intravenous calcium gluconate 20 minutes after aortic clamp release; control group did not.
- Data collected included demographics, surgical details, and intensive care unit (ICU) parameters.
Main Results:
- No significant differences in gender, blood group, or RH factor between groups.
- Statistically significant differences observed in mean systolic blood pressure (p=0.030), diastolic blood pressure (p=0.021), heart rate (p=0.025), mean arterial pressure (p=0.020), pH (p<0.001), and hemoglobin (p=0.018) between groups.
- Ejection Fraction (EF) changes showed a trend towards improvement in the intervention group (13.27±9.16) versus control (8.31±9.80), though not statistically significant (p=0.065).
Conclusions:
- Calcium gluconate administration during cardiopulmonary bypass significantly affected hemodynamic parameters in infants undergoing open-heart surgery.
- Mean diastolic blood pressure decreased, and mean arterial pressure increased significantly in the intervention group compared to the control.
- The study indicates a differential impact of calcium gluconate on hemodynamic stability during pediatric cardiac surgery.
Background:
The incidence of complications after heart surgery is a critical factor in disability, deaths, lengthening hospital stays, and increasing treatment costs. The metabolic balance of certain hormones and electrolytes is necessary for proper cardiac function. In children, various biochemical conditions may cause calcium depletion during heart surgery. The purpose of this study was to determine the effect of calcium gluconate administration during cardiopulmonary bypass on hemodynamic variables and clinical outcomes in infants undergoing open-heart surgery. This study was conducted at Rajaie Cardiovascular Medical and Research Center in 2021 using a controlled randomized clinical trial. A total of 60 patients with open-heart surgery weighing up to 10 kg were included in the study. The first group received an intravenous injection of calcium gluconate 20 min after opening the aortic clamp, and the second group was monitored as a control group. Data collection tools included checklists containing demographics, surgical information, and intensive care unit measures.
Results:
The Chi-square test or Fisher's exact test showed that the frequency distribution of gender, blood group, Rhesus factor (RH), and clinical diagnosis in the two groups of intervention and control was not statistically significant (p < 0.05). The mean and standard deviation of Ejection Fraction (EF) changes (before and after) were 13.27 ± 9.16 in the intervention group and 8.31 ± 9.80 in the control group (p = 0.065). The results of two-way repeated measures ANOVA showed that mean systolic blood pressure (p = 0.030), mean diastolic blood pressure (p = 0.021), mean heart rate (p = 0.025), mean arterial pressure (p = 0.020), mean pH (p < 0.001), and mean hemoglobin (p = 0.018) in the intervention, and control groups were statistically significant.
Conclusions:
In the present study, unlike systolic pressure, mean diastolic blood pressure decreased, and mean arterial pressure increased significantly. As a result, the slope of changes during the study period was different in the intervention and control groups.
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