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Effects of single dose calcium gluconate infusion in hypocalcemic preterm infants
1Women & Infants' Hospital of Rhode Island, Department of Pediatrics, Brown University, Providence 02905-2409, USA.
Insights
A single dose of calcium gluconate effectively treats neonatal hypocalcemia in preterm infants. This therapy raises serum calcium levels and reduces clinical signs like irritability and jitteriness.
Area of Science:
- Neonatalogy
- Pediatric Endocrinology
- Clinical Pharmacology
Background:
- Neonatal hypocalcemia is a common complication in preterm infants.
- Low serum calcium can lead to significant clinical manifestations and adverse outcomes.
Purpose of the Study:
- To evaluate the efficacy of a single calcium gluconate infusion for treating neonatal hypocalcemia in preterm infants.
- To assess the impact on serum calcium levels and clinical signs of hypocalcemia.
Main Methods:
- Prospective, double-blind, placebo-controlled study.
- 43 preterm infants with low total serum calcium were enrolled.
- Serum calcium (total and ionized) and hypocalcemic signs were measured before and after treatment with calcium gluconate or placebo.
Main Results:
- Calcium gluconate infusion significantly increased total and ionized serum calcium levels 3-6 hours post-infusion.
- Clinical signs of hypocalcemia, including irritability and jitteriness, decreased in infants receiving calcium gluconate.
- No significant changes were observed in the placebo group.
Conclusions:
- A single 100 mg/kg dose of calcium gluconate is effective in managing neonatal hypocalcemia in preterm infants.
- Treatment with calcium gluconate improves both biochemical and clinical parameters of hypocalcemia.
- This study supports the use of calcium gluconate for acute management of hypocalcemia in this vulnerable population.
Abstract:
We conducted a prospective, double-blind study of 43 preterm infants to examine the effect of a single calcium gluconate infusion as therapy for neonatal hypocalcemia on serum calcium concentrations and hypocalcemic signs in preterm infants with low total serum calcium concentrations. Total and ionized serum calcium was measured and signs of irritability, jitteriness, and twitching were scored (scale 0-9) by blinded observers before and after receiving one dose of either calcium gluconate (100 mg/kg) or placebo (normal saline). Total and ionized serum calcium increased 3 to 6 hours following the calcium, but not the placebo, infusion. Of the infants with hypocalcemic signs, the average score of hypocalcemic signs decreased in the 11 calcium-treated infants; the 12 infants with hypocalcemic signs showed no change of hypocalcemic signs following treatment with placebo. We conclude from this study that a single dose of calcium gluconate (100 mg/kg) in hypocalcemic preterm infants raise total and ionized serum calcium and decrease clinical signs of hypocalcemia.