Treatment of early-onset neonatal hypocalcemia. Effects on serum calcium and ionized calcium.

For the treatment of early-onset neonatal hypocalcemia, 50 neonates received either a high dose (group H), a low dose (group L), or no parenteral calcium (Ca) (group CON). Groups H and L received parenteral Ca either as a continuous infusion (group C) or by intermittent injection (group I). After the first 24 hours of treatment, groups H, C, and I had higher serum Ca concentrations than did group CON. After the entire 72-hour study period, group H had a lower incidence of hypocalcemia (serum Ca level < 7.0 mg/dL) when compared with all other patients. Although a relatively high Ca intake statistically increased serum Ca levels, eight of 13 patients in group CON (62%) completed the 72-hour study without requiring parenteral Ca. Based on these results, we recommend parenteral Ca treatment for only those patients with persistent hypocalcemia, tetany, or a seizure disorder.