[Effects of calcium gluconate and calcium chloride on cardiocirculatory parameters in man (author's transl)]

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Pharmacology

Background:

• Patients with heart disease often require cardiovascular surgery.
• Intraoperative management of hemodynamics is critical.
• Calcium is essential for myocardial contractility.

Purpose of the Study:

• To compare the effects of calcium gluconate and calcium chloride on hemodynamics, inotropy, and myocardial oxygen consumption.
• To evaluate the efficacy of these calcium preparations during and after cardiosurgical procedures.
• To determine the preferred calcium agent for emergency situations in cardiac surgery.

Main Methods:

• A study involving 44 patients with New York Heart Association (NYHA) functional class II-IV heart disease undergoing cardiosurgery.
• Intravenous administration of calcium gluconate (10 ml 10%) and calcium chloride (5.5%) during and immediately after surgery.
• Monitoring of hemodynamic parameters, inotropic state, and myocardial oxygen consumption.

Main Results:

• Both calcium gluconate and calcium chloride significantly increased blood pressure, left ventricular pressure, total systemic resistance, cardiac index, stroke index, peak dp/dt, and myocardial oxygen consumption.
• Arterial perfusion pressure also increased during extracorporeal circulation with both agents.
• Calcium chloride exhibited more pronounced positive inotropic effects compared to calcium gluconate.

Conclusions:

• Both calcium gluconate and calcium chloride can improve hemodynamic parameters and myocardial oxygen consumption in cardiac surgery patients.
• Calcium chloride appears to be more advantageous than calcium gluconate in emergency settings during anesthesia or resuscitation due to its stronger inotropic effects.