The impact of Gluconate calcium on hypocalcaemia after blood exchange in hyperbilirubinemic newborns

Abstract

Background: Blood exchange is one of therauputic methods for neonatal hyperbilirubinemia. But this method has some complications. One of these complications is hypocalcemia. In some studies, for avoiding from this problem, calcium gluconate injection is recomm ended. But in some studies there was any important difference between calcium treated group and the group without calcium prescription. Due to lack of documented evidences about prevalence of this complication, this study was conducted to compare the result of using calcium gluconate injection in the incidence of hypocalcemia and hyper calcemia. Methods and materials: For this purpose in a randomized controlled clinical trial in Ali_ Asghar pediatric hospital in Zahedan, 40 hyperbilirubin neonates that were hospitalized for blood exchange came into this study. These patients were randomized in two groups so that they were adjusted in terms and preterm delivery. For 22 patients, 1 ml of calcium glucdnate%10 was injected in each 100 ml exchanged blood and for 18 patients (control group), calcium injection wasn’t been done. Calcium serum level was tested before, immediately after and 6 hours after blood exchange in all patients. Data analysis was been done by means of fishers exact test, Chi_ Square and Binomial test. Results: In calcium treated patients, hypocalcaemia wasn’t being present after blood exchange. But in non _ calcium treated patients hypo calcemia was seen in 4 cases (%22.4) after blood exchange (P < 0.013). All of these 4 cases were preterm. In calcium treated patients hypocalcaemia had a significant increase after exchange especially in term neonates (P