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Report of Two Cases

Graziano C. Carlon, MD; William S. Howland, MD; Paul L. Goldiner, MD; Roberta C. Kahn, MD; Giancarlo Bertoni, MD; Alan D. Turnbull, MD

Arch Surg. 1978;113(7):882-885.

Abstract
• Calcium chloride, 7 mg/kg, and calcium gluconate, 20 mg/kg, were administered to patients with low or low-normal levels of serum ionized calcium. Both patients had low blood pressure and cardiac index, and did not respond to digitalis, volume expansion, and β-adrenergic stimulation with dopamine. Administration of calcium caused rapid increase of serum ionized calcium levels, decrease of serum potassium levels, and development of severe cardiac arrhythmias. Atrioventricular dissociation and further fall of cardiac index and blood pressure were common features of both cases. Administration of exogenous calcium can cause severe complications, even when theoretically indicated.

(Arch Surg 113:882-885, 1978)

Author Affiliations
From the Department of Anesthesiology, Memorial Sloan-Kettering Cancer Center, New York.

Footnotes
Accepted for publication March 15, 1978.

Reprint requests to Department of Anesthesiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021 (Dr Carlon).

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