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Heparin effect on ionised calcium concentration
Clinica Chimica Acta; International Journal of Clinical Chemistry
|November 11, 1981
Summary
Heparin administration can significantly lower plasma ionised calcium levels. This effect was observed both in vitro and in vivo during haemodialysis, indicating a crucial consideration for clinical practice.
Area of Science:
- Biochemistry
- Clinical Chemistry
- Pharmacology
Background:
- Heparin is a widely used anticoagulant.
- The potential impact of heparin on electrolyte balance, specifically ionised calcium, requires thorough investigation.
- Accurate measurement of ionised calcium is critical in various clinical settings.
Purpose of the Study:
- To investigate the effect of heparin on plasma ionised calcium levels.
- To determine the dose-dependent relationship between heparin concentration and ionised calcium reduction.
- To assess the in vivo effect of heparinisation on ionised calcium during haemodialysis.
Main Methods:
- In vitro addition of increasing heparin concentrations (1-2 U/ml) to whole blood from healthy subjects.
- In vivo study involving intravenous injection of 10,000 U heparin in patients undergoing haemodialysis.
- Measurement of plasma ionised calcium levels before and after heparin administration.
Main Results:
- In vitro: No significant change at 1 U/ml, but a significant fall of 0.02 mmol/l at 2 U/ml, with further decreases at higher concentrations.
- Heparin from different manufacturers yielded similar results.
- In vivo: A consistent and significant average fall of 0.03 mmol/l in ionised calcium was observed during haemodialysis.
Conclusions:
- Heparin causes a dose-dependent decrease in plasma ionised calcium.
- The observed hypocalcaemic effect of heparin is clinically relevant, particularly in patients undergoing procedures like haemodialysis.
- Monitoring of ionised calcium levels may be warranted in patients receiving heparin, especially those with renal impairment.