Evans PA, Madira W, Riyatt MS, Errington M, Heptinstall S. Changes in plasma ionised calcium within 24 hours of trauma in patients infused with the calcium containing colloid Haemaccel during fluid resuscitation.
J Accid Emerg Med 1997;
14:73-5. [PMID:
9132195 PMCID:
PMC1342871 DOI:
10.1136/emj.14.2.73]
[Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE
To determine the changes in ionised plasma calcium levels over a 24 h period in patients sustaining blunt trauma injuries and infused with the calcium containing colloid Haemaccel (6.25 mmol/ litre Ca2+).
METHODS
The study was carried out on 24 trauma patients who attended the accident and emergency (A&E) department of the Leicester Royal Infirmary and required fluid resuscitation. Nineteen patients, with a mean injury severity score (ISS) of 14 (range 6 to 36), were given an infusion of Haemaccel; five patients in the control group with an ISS of 12 (range 6 to 19) were infused non-calcium-containing crystalloid. All types of fluids were recorded and serial plasma ionised calcium values were measured over a 24 h period.
RESULTS
The mean pre-Haemaccel ionised calcium value fell to 0.71 mmol/litre following trauma. The mean values (mmol/litre) obtained in patients infused with Haemaccel were measured at 2, 4, 8, and 24 h. In the Haemaccel group these values were 1.38 (SD 0.34), 1.40 (0.44), 1.23 (0.27), and 1.18 (0.31) (at least P < 0.001 v baseline). The rise in calcium at 2 h was proportional to the volume of Haemaccel infused (r = 0.917; P < < 0.001).
CONCLUSIONS
In all patients the plasma ionised calcium rose on infusion of Haemaccel and in a least one measurement 50% of patients developed hypercalcaemia (Ca2+ < 1.30 mmol/litre). The clinical significance of this is at present unclear.
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