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Patterns of total and ionized calcium and other electrolytes in plasma during and after general surgery

Summary

Thirteen patients were studied during two hours of anaesthesia for abdominal operations and for an hour post-operatively. Serial venous blood samples were taken for determination of plasma total and ionized calcium, acid-base variables, Na, K, Mg, PO4 total proteins and parathyroid hormone. One group of patients received 5 per cent dextrose/water and the other 5 per cent dextrose in Ringer’s solution, at 250 ml per hour. Total and ionized calcium levels decreased toward the end of operation and an hour later, associated with respiratory alkalosis. Parathyroid hormone increased at the end of operation, as an effect of the decreased ionized calcium. The general effect was mild haemodilution with all the other electrolytes decreasing, as did total protein concentration.

Résumé

Des prélèvements veineux ont été faits chez 13 opérvs durant des anesthésies d’une durée de 2 heures et ont été répétés durant la première heure postopératoire. Les paramètres étudiés ont été le calcium total et le calcium ionisé, l’equilibre acido-basique, le sodium, le potassium, le magnésium et les phosphates, les protvines totales et la parathormone. Un groupe de patients a reçu du dextrose à 5 pour cent dans l’eau et l’autre groupe a regu une solution de dextrose à 3 pour cent dans le Ringer, à raison de 250 ml à l’heure.

Les taux de calcium total et ionisés étaient diminués vers la fin de l’intervention et dans l’heure suivant l’intervention, ceci associé avec une alcalose respiratoire. Les taux de parathormone s’élevaient en fin d’intervention, un effet lié à la diminution du calcium ionisé. Quant aux autres électrolytes et aux protéines totales, leurs taux reflétaient une hémodilution légere.

References

  1. 1.

    Williams, R.J.P. &Wacker, W.E.C. Cation balance in biological systems. J.A.M.A.201: 96 (1967).

    PubMed  Article  CAS  Google Scholar 

  2. 2

    Entman, M.L. Calcium and cardiac contractility. Amer. J. Med. Sciences259: 164 (1970).

    CAS  Google Scholar 

  3. 3.

    Moore, E.W. Ionized calcium in normal serum, ultrafiltrar.es, and whole blood determined by ion-exchange electrodes. J. Clin. Invest.49: 318 (1970).

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Arnaud, CD., Tsao, H.S., &Littledike, T. Radioimmunoassay of human parathyroid hormone in serum. J. Clin. Invest.50: 21 (1971).

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    Kaplan, E.L., Hill, B.J., Locke, S., &Peskin, G.W. Acid-base balance and parathyroid function: metabolic alkalosis and hyperparathyroidism. Surgery70: 198 (1971).

    PubMed  CAS  Google Scholar 

  6. 6.

    Hinkle, J.E. &Cooperman, L.H. Serum ionized calcium changes following citrated blood transfusion in anaesthetized man. Br. J. Anaes.43: 1108 (1971).

    Article  CAS  Google Scholar 

  7. 7.

    Das, J.B., Eraklis, A.J., Adams, J.G., Jr., &Gross, R.E. Changes in serum ionic calcium during cardiopulmonary bypass with hemodilution. J. Thorac. Cardiovasc. Surg.62: 449 (1971).

    PubMed  CAS  Google Scholar 

  8. 8.

    Killen, D.A., Grogan, E.L., II Gower, R.E., Collins, I.S., &Collins, H.A. Effect of ACD blood prime on plasma calcium and magnesium. Ann. Thorac. Surg.13: 371 (1972).

    PubMed  CAS  Article  Google Scholar 

  9. 9.

    Johnson, A.E., Radde, I.C., Nisbet, H.I.A., &Taylor, U. Effects of altering calcium in haemodiluted pump primes on sodium and potassium in children undergoing open-heart operations. Can. Anaesth. Soc. J.19: 517 (1972).

    Google Scholar 

  10. 10.

    Moffitt, E.A., Tarhan, S., Goldsmith, R.S., Pluth, J.R., &McGoon, D.C. Patterns of total and ionized calcium and other electrolytes in plasma during and after cardiac surgery. J. Thorac. Cardiovasc. Surg.65: 751 (1973).

    PubMed  CAS  Google Scholar 

  11. 11.

    Nisbet, H.I.A., Mathur, A.K., Dobbinson, T.L., Steward, D.J., & Volgyesi, G.A. The effect of artificial ventilation on FRC and arterial oxygenation. 3. Low and normal arterial carbon dioxide tension during ventilation with sine wave and inspiratory hold patterns. Canad. Anaesth. Soc. J. In Press.

  12. 12.

    Moffitt, E.A., Schnelle, N., Rodriguez, R., Lee, R.A., &Judd, E.S. Effects of intra- venously administered solutions on electrolytes and energy substrates during surgery. Canad. Anaesth. Soc. J.21: 285 (1974).

    PubMed  CAS  Article  Google Scholar 

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Correspondence to R. Rodriguez or R. R. Jones or M. A. Adson or E. A. Moffitt.

Additional information

This work was supported in part by grant GM 14919 from the National Institutes of Health, Public Health Service.

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Rodriguez, R., Jones, R.R., Adson, M.A. et al. Patterns of total and ionized calcium and other electrolytes in plasma during and after general surgery. Canad. Anaesth. Soc. J. 23, 15–21 (1976). https://doi.org/10.1007/BF03004990

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Keywords

  • CANADIAN Anaesthetist
  • Carbon Dioxide Tension
  • Respiratory Alkalosis
  • Ionize Calcium Level
  • Intravenous Solution