用三羟甲基氨基甲烷缓冲的酸性枸橼酸盐葡萄糖溶液血液进行换血时的离子钙。
Ionized calcium in exchange transfusion with THAM-buffered ACD blood.
作者信息
Friedman Z, Hanley W B, Radde I C
出版信息
Can Med Assoc J. 1972 Oct 21;107(8):742-5.
In 20 exchange transfusions with THAM-buffered ACD blood 5 ml. of 2% calcium gluconate (8 mg. elemental calcium) was injected after each 100 ml. of blood exchanged. Plasma ionized calcium decreased significantly during the procedure, although after each injection of calcium gluconate, levels returned briefly to normal. Ten minutes after the end of exchange ionized calcium had returned to pre-exchange levels and remained there until at least 30 mins. postexchange.Total calcium also increased significantly. Short periods of extreme hypercalcemia (between 7 and 8 mEq./l.) were noted after each injection of calcium gluconate.The amount of calcium gluconate was insufficient to counteract the calcium-chelating effect of citrate. If no heparinized blood is available we suggest adding heparin and calcium chloride to THAM-buffered ACD blood to avoid the repeated sudden fluctuations between low and high calcium ion activity.
在使用THAM缓冲的ACD血液进行20次换血过程中，每换血100毫升后注射5毫升2%葡萄糖酸钙（8毫克元素钙）。换血过程中血浆离子钙显著下降，尽管每次注射葡萄糖酸钙后，离子钙水平会短暂恢复正常。换血结束10分钟后，离子钙已恢复到换血前水平，并至少维持到换血后30分钟。总钙也显著增加。每次注射葡萄糖酸钙后均出现短时间的极度高钙血症（7至8毫当量/升）。葡萄糖酸钙的量不足以抵消柠檬酸盐的钙螯合作用。如果没有肝素化血液，我们建议在THAM缓冲的ACD血液中添加肝素和氯化钙，以避免钙离子活性在低和高之间反复突然波动。
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