Change of ionized calcium level in the first 48 hours of age of preterm newborns administered with two different dosages of intravenous calcium gluconate

  • Anton Wibowo Department of Child Health, Medical School, Padjadjaran University, Hasan Sadikin General Hospital
  • Dedi Rachmadi Sambas Department of Child Health, Medical School, Padjadjaran University, Hasan Sadikin General Hospital
  • Abdurachman Sukadi Department of Child Health, Medical School, Padjadjaran University, Hasan Sadikin General Hospital
DOI: https://doi.org/10.14238/pi50.2.2010.96-100
Keywords: Preterm newborn, early onset hypocalcemia, 10% calcium gluconate

Abstract

Background Physiologically, serum calcium level declines till nadir
in a few hours after birth and continues for 24-48 hours. No study
performed in order to know the alteration ofionized calcium level
of newborn in the first 48 hours of age. The sick newborn must
have parenteral calcium to avoid hypocalcemia but there is still
no agreement about the dose.
Objective To determine the change of ionized calcium level in
the first 48 hours of age of preterm newborns administered with
peripheral drip intravenous 10% calcium gluconate of2.6 mIJkg/
day and 5 mUkg/day.
Methods An open labeled randomized controlled clinical trial
was performed between April and June 2009. After birth blood
specimen of preterms was obtained for leukocyte, platelet,
magnesium, phosphorous, and ionized calcium measurements.
Subjects received either 2.6 mL/kg/day or 5 mL/kg/day of
peripheral drip intravenous 10% calcium gluconate immediately
after birth for 48 hours. Blood specimens was obtained again on
48 hours of age for ionized calcium. This study were analyzed
using repeated measures analysis of varians.
Results Forty preterm newborns (20 subjects each group) were
analyzed. There was no statistical difference between both
doses (Factor-A) on 48 hours ionized calcium level (P=0.33)
and ionized calcium level alteration based on time (Factor-B)
(P=0.20). Interaction between both factors was significantly
different (P=0.035).
Conclusion Ionized calcium level in 48 hours of age of preterm
newborn administered with both doses of 10% calcium gluconate is
not different but dose of2.6 mL/kg/day yields physiologic alteration
of ionized calcium level compared with 5 mL/kg/day.

References

1. Singhal A. H ypocalcemia (homepage on the internet). 2006
(cited 2008 July 12). Available from: http://www.eMedicine.
com.
2. Namgung R, Tsang RC. Hypocalcemia. In: Rudolph AM,
Rudolph CD, Hosteter MK, Lister G, Siegel NJ, editors.
Rudolph's pediatrics. 2 lst ed. New York: McGraw-Hill, 2003;
p. 160-3.
3. Koo WWK, Tsang RC. Calcium and magnesium homeostasis.
In: MacDonald MG, Mullet MD, Seshia MM, editors.
100 • Paediatr Indones, Vol. 50, No. 2, March 2010
Avery's neonatology: pathophysiology & management of
the newborn. 6th ed. Philadelphia: Lippincott Williams &
Wilkins, 2005; p. 848-62.
4. Rigo J, Curtis MD. Disorders of calcium, phosphorus, and
magnesium metabolism. In: Martin RJ, Fanaroff AA, Walsh
MC, editors. Fanaroff and Martin's neonatal-perinatal
medicine. 8th ed. New York: Mosby, 2006; p. 1-37.
5. Klaus MH, Fanaroff AA. Care of the high-risk neonate. 5th
ed. Philadelphia: WB Saunders Company; 2001.
6. Huttner KM. Hypocalcemia, hypercalcemia, and hypermagnesemia.
In: Cloherty JP, Eichenwald EC, Stark AR,,
editors. Manual of neonatal care. 5th ed. Philadelphia:
Lippincott Williams & Wilkins, 2004; p. 580-8.
7. Cloherty JP, Parritz AL. Maternal conditions that effect the
fetus. In: Cloherty JP, Eichenwald EC, Stark AR, editors.
Manual of neonatal care. 5th ed. Philadelphia: Lippincott
Williams & Wilkins, 2004; p. 16.
8. Mainali E. Fluid and electrolytes [CD-ROM]. Washington:
USAID; 2006.
9. Blackbum ST. Maternal, fetal, and neonatal physiology, a
clinical perspective. 3rd ed. St.Louis US: Saunders, 2007.
10. Sann L, David L, Chayvialle JA, Lasne Y, Bethenod M. Effect
of early oral calcium supplementation on serum calcium and
immunoreactive calcitonin concentration in preterm infants.
Arch Dis Child. 1980;55:611-5.
Published
2010-04-30
How to Cite
1.
Wibowo A, Sambas D, Sukadi A. Change of ionized calcium level in the first 48 hours of age of preterm newborns administered with two different dosages of intravenous calcium gluconate. PI [Internet]. 30Apr.2010 [cited 19Apr.2024];50(2):96-00. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1213
Issue
Vol 50 No 2 (2010): March 2010
Section
Articles

Authors who publish with this journal agree to the following terms:

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Received 2017-01-29
Accepted 2017-01-29
Published 2010-04-30