Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis · 2024
Comparison of different concentrations of calcium gluconate added in replacement fluid to maintain ionised calcium levels during therapeutic plasma exchange procedures.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Prinja Nippun, Hans Rekha, Sahni Aarushi, Kumari Sangeeta, Paul Preeti, Lamba Divjot Singh, Takkar Aastha, Mahesh Karthik Vinay, Sharma Ratti Ram
Аннотация
INTRODUCTION: Therapeutic plasma exchange (TPE) is generally well tolerated but Anticoagulant Citrate Dextrose Solution A (ACD-A) can cause citrate mediated hypocalcaemia so, adding calcium gluconate to the replacement fluid is effective in preventing this complication. We aimed to compare the effect of different concentrations of 10 % calcium gluconate (9.3 mg of elemental calcium/100 ml Vs 18.6 mg of elemental calcium/100 ml) added to 5 % Human Serum Albumin (HSA) on intraprocedural and post procedural ionised calcium (iCa2+) levels in patients with neurological conditions undergoing TPE.
MATERIAL AND METHODS: This study comprised of 100 TPE procedures divided into two groups of 50 each. In group 1, 5 ml of 10 % calcium gluconate was added in 500 ml of 5 % HSA (9.3 mg of elemental calcium/100 ml) and in group 2, 10 ml of 10 % calcium gluconate was added (18.6 mg of elemental calcium/100 ml) in 5 % of HSA. Ionised calcium was noted-pre, intra and post-procedure and compared within the groups along with other procedural parameters and adverse events if any.
RESULTS: We observed that mean intraprocedural ionised calcium levels were comparable (p = 0.579) in both the groups, but post-procedural iCa2+ levels significantly decreased (p = 0.003) in group-1 as compared to group-2. Symptomatic hypocalcaemia was seen in 14 % of patients group 1 compared to 2 % in group-2. Vasovagal reactions were 8 % in group-1 % and 2 % in group-2.
CONCLUSION: Prophylactic addition of 18.6 mg of elemental calcium/100 ml of 5 % HSA is safe to maintain levels of iCa2+ throughout the procedure with lower chances of adverse events related to hypocalcaemia.
MATERIAL AND METHODS: This study comprised of 100 TPE procedures divided into two groups of 50 each. In group 1, 5 ml of 10 % calcium gluconate was added in 500 ml of 5 % HSA (9.3 mg of elemental calcium/100 ml) and in group 2, 10 ml of 10 % calcium gluconate was added (18.6 mg of elemental calcium/100 ml) in 5 % of HSA. Ionised calcium was noted-pre, intra and post-procedure and compared within the groups along with other procedural parameters and adverse events if any.
RESULTS: We observed that mean intraprocedural ionised calcium levels were comparable (p = 0.579) in both the groups, but post-procedural iCa2+ levels significantly decreased (p = 0.003) in group-1 as compared to group-2. Symptomatic hypocalcaemia was seen in 14 % of patients group 1 compared to 2 % in group-2. Vasovagal reactions were 8 % in group-1 % and 2 % in group-2.
CONCLUSION: Prophylactic addition of 18.6 mg of elemental calcium/100 ml of 5 % HSA is safe to maintain levels of iCa2+ throughout the procedure with lower chances of adverse events related to hypocalcaemia.