13/03/2025
I've been writing contents on different "WHYS" we administer some particular injections to a patient reacting to blood transfusion, before and after blood transfusion, and here is another "WHY" we administer IV Calcium gluconate to a patient after blood transfusion.
Calcium gluconate injection is often administered after blood transfusion to help manage the effects of citrate, a preservative commonly used in blood products.
Here are some reasons why:
1. Reverses citrate-induced hypocalcemia: Citrate can bind to calcium ions in the blood, leading to a decrease in ionized calcium levels (hypocalcemia). Calcium gluconate helps to replenish calcium stores and reverse hypocalcemia.
2. Prevents tetany and muscle cramps: Hypocalcemia can cause muscle cramps, tetany, and other symptoms. Calcium gluconate helps to prevent these complications by maintaining normal calcium levels.
3. Supports cardiac function: Calcium is essential for cardiac function, and hypocalcemia can lead to cardiac arrhythmias and decreased cardiac contractility. Calcium gluconate helps to maintain normal cardiac function.
4. Reduces the risk of citrate toxicity: Citrate can accumulate in the blood and cause toxicity, particularly in patients with liver or kidney dysfunction. Calcium gluconate helps to reduce the risk of citrate toxicity by binding to citrate and promoting its excretion.
5. Maintains coagulation: Calcium is necessary for coagulation, and hypocalcemia can lead to coagulopathy.
Calcium gluconate helps to maintain normal coagulation and prevent bleeding complications.
The administration of calcium gluconate injection after blood transfusion is typically guided by the following factors:
1. Volume of blood transfused: Larger volumes of blood transfused may require more calcium gluconate to counteract the effects of citrate. For example, a patient that will collect 3 or more units of blood.
2. Patient's underlying medical condition: Patients with liver or kidney dysfunction, or those with pre-existing hypocalcemia, may require more calcium gluconate.
3. Severity of hypocalcemia: Patients with severe hypocalcemia may require more aggressive calcium replacement.
The dose and frequency of calcium gluconate injection will depend on the individual patient's needs and the specific clinical scenario.
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