Defining the optimal calcium repletion dosing in patients requiring activation of massive transfusion protocol

Massive transfusion protocols (MTP) commonly result in severe hypocalcemia due to the calcium-binding affinity of citrate in blood components. The purpose of this study is to determine the optimal grams (g) of citrate to repletion calcium (Ca) milliequivalents (mEq) (Citrate:Ca) ratio to reduce 30-d...

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Bibliographic Details
Published in:The American journal of emergency medicine 2023-08, Vol.70, p.96-100
Main Authors: Robinson, Andrew, Rech, Megan A., DeChristopher, Phillip J., Vaughn, Alex, Rubino, John, Bannister, Erika, Moore, Mary E., Chang, Kevin
Format: Article
Language:English
Subjects:
Blood
Blood banks
Blood products
Calcium
Citrat
Citric acid
Drug dosages
Emergency medical care
Hemodynamics
Hypocalcemia
Massive transfusion
Mortality
Regression analysis
Transfusion
Trauma
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Summary:Massive transfusion protocols (MTP) commonly result in severe hypocalcemia due to the calcium-binding affinity of citrate in blood components. The purpose of this study is to determine the optimal grams (g) of citrate to repletion calcium (Ca) milliequivalents (mEq) (Citrate:Ca) ratio to reduce 30-day mortality. This was a retrospective, single-centered, cohort study at a level 1 trauma center evaluating trauma and surgical patients in need of MTP activation from January 1, 2010–July 31, 2021. Patients with severe hypocalcemia at baseline, defined as ionized calcium (iCa)
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2023.05.017