Research output: Contribution to journal › Review article › peer-review
Calcium Administration During Weaning From Cardiopulmonary Bypass : A Narrative Literature Review. / Lomivorotov, Vladimir V.; Leonova, Elizaveta A.; Belletti, Alessandro et al.
In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 34, No. 1, 01.2020, p. 235-244.Research output: Contribution to journal › Review article › peer-review
}
TY - JOUR
T1 - Calcium Administration During Weaning From Cardiopulmonary Bypass
T2 - A Narrative Literature Review
AU - Lomivorotov, Vladimir V.
AU - Leonova, Elizaveta A.
AU - Belletti, Alessandro
AU - Shmyrev, Vladimir A.
AU - Landoni, Giovanni
N1 - Copyright © 2019 Elsevier Inc. All rights reserved.
PY - 2020/1
Y1 - 2020/1
N2 - The search for safe and effective patient management strategies during weaning from cardiopulmonary bypass is ongoing; intravenous calcium is occasionally used as a first-line drug. The physiologic role of calcium suggests that it can support the function of the cardiovascular system during this critical period. Patients may be mildly hypocalcemic after cardiopulmonary bypass; however, this degree of hypocalcemia does not significantly impair the cardiovascular system. The transient beneficial effects of calcium administration (increase in arterial blood pressure, systemic vascular resistance, cardiac index, stroke volume, and coronary perfusion pressure) might be helpful in cases of moderate contractility reduction or vasoplegia. Nonetheless, effects on clinically relevant endpoints are unknown, and possible systemic side effects, such as transient reduction in internal mammary artery graft flow, attenuation of the effects of β-sympathomimetics, “stone heart” phenomenon, and pancreatic cellular injury, may limit the use of calcium salts. Further studies are needed to expand the understanding of the effects of calcium administration on patient outcomes.
AB - The search for safe and effective patient management strategies during weaning from cardiopulmonary bypass is ongoing; intravenous calcium is occasionally used as a first-line drug. The physiologic role of calcium suggests that it can support the function of the cardiovascular system during this critical period. Patients may be mildly hypocalcemic after cardiopulmonary bypass; however, this degree of hypocalcemia does not significantly impair the cardiovascular system. The transient beneficial effects of calcium administration (increase in arterial blood pressure, systemic vascular resistance, cardiac index, stroke volume, and coronary perfusion pressure) might be helpful in cases of moderate contractility reduction or vasoplegia. Nonetheless, effects on clinically relevant endpoints are unknown, and possible systemic side effects, such as transient reduction in internal mammary artery graft flow, attenuation of the effects of β-sympathomimetics, “stone heart” phenomenon, and pancreatic cellular injury, may limit the use of calcium salts. Further studies are needed to expand the understanding of the effects of calcium administration on patient outcomes.
KW - calcium
KW - hypocalcemia
KW - inotropes
KW - vasopressors
KW - weaning from cardiopulmonary bypass
UR - http://www.scopus.com/inward/record.url?scp=85069704809&partnerID=8YFLogxK
U2 - 10.1053/j.jvca.2019.06.016
DO - 10.1053/j.jvca.2019.06.016
M3 - Review article
C2 - 31350149
AN - SCOPUS:85069704809
VL - 34
SP - 235
EP - 244
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 1
ER -
ID: 21060365