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Reversal of lethal citrate intoxication by intravenous infusion of calcium. An experimental study in pigs

Vagianos, C; Steen, Stig LU ; Masson, P; Fåhraeus, Thomas LU ; Sjöberg, Trygve LU ; Kugelberg, J and Solem, Jan Otto LU (1990) In Acta Chirurgica Scandinavica 156(10). p.671-675
Abstract
Intravenous infusions of 750 and 1000 ml 2.2% sodium citrate were given over a 60 min period to 17 pigs to study its effect on aortic pressure, electrocardiogram, ionised calcium, and citrate clearance. In group 1 (seven pigs) the animals did not receive calcium and the median survival time was 30 min (range 20-70 min). In groups 2 and 3 (five in each group) the pigs were treated with calcium chloride infusions (1 ml 10% calcium chloride to 10 ml citrate) and they all survived. In group 1 the ionised calcium concentrations in blood fell to values below 0.4 mmol/l, after which the blood pressure dropped abruptly. In the animals treated with calcium the mean ionised calcium concentration fell to 0.6 mmol/l, whereas total calcium increased to... (More)
Intravenous infusions of 750 and 1000 ml 2.2% sodium citrate were given over a 60 min period to 17 pigs to study its effect on aortic pressure, electrocardiogram, ionised calcium, and citrate clearance. In group 1 (seven pigs) the animals did not receive calcium and the median survival time was 30 min (range 20-70 min). In groups 2 and 3 (five in each group) the pigs were treated with calcium chloride infusions (1 ml 10% calcium chloride to 10 ml citrate) and they all survived. In group 1 the ionised calcium concentrations in blood fell to values below 0.4 mmol/l, after which the blood pressure dropped abruptly. In the animals treated with calcium the mean ionised calcium concentration fell to 0.6 mmol/l, whereas total calcium increased to more than 7 mmol/l. The aortic pressure was consistently within normal values in the groups treated with calcium, but in the group that was not treated the blood pressure fell dramatically. There was no correlation between electrocardiographic changes and ionised calcium concentrations. In summary, calcium was an effective antidote to lethal citrate intoxication, and the only reliable method of determining the necessary dose of calcium was monitoring of ionised calcium concentrations. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Chirurgica Scandinavica
volume
156
issue
10
pages
671 - 675
publisher
Almqvist & Wiksell
external identifiers
  • pmid:2264424
  • scopus:0025011675
ISSN
0001-5482
language
English
LU publication?
yes
id
26fcbaf5-7ad4-42e4-9f6f-7d091b438fa8 (old id 1105515)
date added to LUP
2008-08-05 16:57:27
date last changed
2017-01-01 07:02:26
@article{26fcbaf5-7ad4-42e4-9f6f-7d091b438fa8,
  abstract     = {Intravenous infusions of 750 and 1000 ml 2.2% sodium citrate were given over a 60 min period to 17 pigs to study its effect on aortic pressure, electrocardiogram, ionised calcium, and citrate clearance. In group 1 (seven pigs) the animals did not receive calcium and the median survival time was 30 min (range 20-70 min). In groups 2 and 3 (five in each group) the pigs were treated with calcium chloride infusions (1 ml 10% calcium chloride to 10 ml citrate) and they all survived. In group 1 the ionised calcium concentrations in blood fell to values below 0.4 mmol/l, after which the blood pressure dropped abruptly. In the animals treated with calcium the mean ionised calcium concentration fell to 0.6 mmol/l, whereas total calcium increased to more than 7 mmol/l. The aortic pressure was consistently within normal values in the groups treated with calcium, but in the group that was not treated the blood pressure fell dramatically. There was no correlation between electrocardiographic changes and ionised calcium concentrations. In summary, calcium was an effective antidote to lethal citrate intoxication, and the only reliable method of determining the necessary dose of calcium was monitoring of ionised calcium concentrations.},
  author       = {Vagianos, C and Steen, Stig and Masson, P and Fåhraeus, Thomas and Sjöberg, Trygve and Kugelberg, J and Solem, Jan Otto},
  issn         = {0001-5482},
  language     = {eng},
  number       = {10},
  pages        = {671--675},
  publisher    = {Almqvist & Wiksell},
  series       = {Acta Chirurgica Scandinavica},
  title        = {Reversal of lethal citrate intoxication by intravenous infusion of calcium. An experimental study in pigs},
  volume       = {156},
  year         = {1990},
}