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British Journal of Anaesthesia, 1978, Vol. 50, No. 9 951-957
© 1978 The Board of Management and Trustees of the British Journal of Anaesthesia

other

CHANGES IN IONIZED CALCIUM AND OTHER PLASMA CONSTITUENTS ASSOCIATED WITH CARDIOPULMONARY BYPASS

R. N. WESTHORPE, M.B., B.S., F.F.A.R.C.S.*, Z. VARGHESE, B.SC., B.PHARM., M.SC., A. PETRIE, M.SC.**, M. R. WILLS, M.D., M.R.C.P., M.R.C.PATH. and J. LUMLEY, M.B., B.S., F.F.A.R.C.S., D.A.*

*Department of Anaesthetics, Royal Postgraduate Medical School, Du Cane Road, London W12.
**Department of Medical Statistics, Royal Postgraduate Medical School, Du Cane Road, London W12.
Department of Metabolic Unit, Royal Free Hospital Medical School, Pond Street, London NW3 2QG.

Plasma concentrations of calcium fractions, proteins, phosphate and magnesium were measured before, during and after cardiopulmonary bypass in 15 patients undergoing cardiac surgery. When calcium chloride was added to a pump priming solution which contained little or no blood, the concentrations of all calcium fractions were significantly greater after bypass than before, with a mean ionized calcium concentration of 1.52 mmol litre–1 plasma water, 30 min after completion of bypass. This iatrogenic hypercalcaemia was increased significantly by the administration of more than 10 mg kg–1 calcium chloride in the first 30 min after bypass. Other plasma constituents showed the dilutional effect of the pump prime during bypass and only the magnesium concentration failed to return towards normal values after operation.


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