𝗖𝗔𝗟𝗖𝗜𝗨𝗠 𝗖𝗢𝗥𝗥𝗘𝗖𝗧𝗜𝗢𝗡 𝗜𝗡 𝗦𝗘𝗩𝗘𝗥𝗘 𝗦𝗬𝗠𝗣𝗧𝗢𝗠𝗔𝗧𝗜𝗖 𝗛𝗬𝗣𝗢𝗖𝗔𝗟𝗖𝗘𝗠𝗜𝗔
💥10ml of 10% Calcium gluconate contains 1gm of calcium gluconate equivalent to 90mg of elemental calcium
➡️ 9mg/ml or 0.47 mEq/ml elemental calcium
💥10ml of 10% calcium chloride contains 1gm calcium chloride equivalent to 270 mg of elemental calcium
➡️27mg/ml or 1.4 mEq/ml elemental calcium
💥Calcium gluconate is preferred to calcium chloride because it is less likely to cause tissue necrosis if extravasated.
𝗜𝗻𝘁𝗿𝗮𝘃𝗲𝗻𝗼𝘂𝘀 𝗰𝗮𝗹𝗰𝗶𝘂𝗺 𝗱𝗼𝘀𝗶𝗻𝗴 — Initially, IV calcium (1 or 2 g of calcium gluconate, equivalent to 90 or 180 mg elemental calcium, in 50 mL of 5% dextrose or normal saline) can be infused over 10 to 20 minutes. The bolus may be repeated after 10 to 60 minutes, if needed to resolve symptoms.
The calcium should not be given more rapidly, because of the risk of serious cardiac dysfunction, including systolic arrest.
The bolus dose of calcium gluconate will raise the serum calcium concentration for only two or three hours, as a result, it should be followed by a slow infusion of calcium in patients with persistent hypocalcemia.
An IV solution containing 1 mg/mL of elemental calcium is prepared by adding 11 g of calcium gluconate (11 Ampoules of 10ml 10% calcium gluconate equivalent to 1000 mg elemental calcium) to normal saline or 5% dextrose water to provide a final volume of 1000 mL.
This solution is administered at an initial infusion rate of 50 mL/hour (equivalent to 50 mg elemental calcium/hour).
The dose can be adjusted to maintain the serum calcium concentration at the lower end of the normal range (with the serum calcium corrected for any abnormalities in serum albumin as noted above).
Patients typically require 0.5 to 1.5 mg/kg of elemental calcium per hour.
The infusion should be prepared with the following considerations:
●The calcium should be diluted in dextrose and water or saline because concentrated calcium solutions are irritating to veins.
●The IV solution should not contain bicarbonate or phosphate, which can form insoluble calcium salts. If these anions are needed, another IV line (in another limb) should be used.
IV calcium should be continued until the patient is receiving an effective regimen of oral calcium and vitamin D and serum calcium levels are normal.
Source: UpToDate