Wednesday October 19, 2005
Hypocalcemia in massive transfusion

Ideally you should not "reflexly" replace low calcium after massive transfusion as hypocalcemia is usually transient (citrate get metabolize through liver very quickly). Replacement required only if there are clinical signs of hypocalcemia particularly prolong QT interval. It is advisible to follow "ionized calcium" if replacement desired. Another electrolyte to keep eye on is Magnesium as citrate has an equal binding affinity for ionized magnesium.

See manual Massive transfusion in our "M" search at www.icuroom.net

References: click on link to get article:
1. Transfusion for Massive Blood Loss - Trauma.org
2. Management of prolonged QT interval during a massive transfusion: calcium, magnesium or both? - Canadian Journal of Anesthesia 47:792-795 (2000)