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Ionised calcium levels in major trauma patients who received blood en route to a military medical treatment facility

Kyle, Tony, Greaves, Ian, Benyon, Anthony, Whitaker, Vicky and Smith, Jason (2018) Ionised calcium levels in major trauma patients who received blood en route to a military medical treatment facility. Emergency Medicine Journal. ISSN 1472-0205

Item Type: Article

Abstract

Background Hypocalcaemia is a common metabolic derangement in critically ill patients. Blood transfusion can also contribute to depleted calcium levels. The aims of this study were to identify the incidence of hypocalcaemia in military trauma patients receiving blood products en route to a deployed hospital facility and to determine if intravenous calcium, given during the prehospital phase, has an effect on admission calcium levels.

Methods This was a retrospective review of patients transported by the UK Medical Emergency Response Team in Afghanistan between January 2010 and December 2014 who were treated with blood products in the prehospital setting. Total units of blood products administered, basic demographics, Injury Severity Score and trauma type were collected. Ionised serum calcium levels on admission to hospital were compared between those who received blood products without prehospital intravenous calcium supplemental therapy (non-treatment) and patients who were treated with 10 mL of intravenous calcium chloride (10%) concurrently with blood products (treatment).

Results The study included 297 patients; 237 did not receive calcium and 60 did. The incidence of hypocalcaemia in the non-treatment group was 70.0% (n=166) compared with 28.3% (n=17) in the treatment group. Serum calcium levels were significantly different between the groups (1.03 mmol/L vs 1.25 mmol/L, difference 0.22 mmol/L, 95% CI 0.15 to 0.27). In the non-treatment group, 26.6% (n=63) had calcium levels within the normal range compared with 41.7% (n=25) in those who received calcium. There was a dose response of calcium level to blood products with a significant decrease in calcium levels as the volume of blood products increased.

Conclusion Trauma patients who received blood products were at high risk of hypocalcaemia. Aggressive management of these patients with intravenous calcium during transfusion may be required.

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More Information

Depositing User: Tony Kyle

Identifiers

Item ID: 13094
Identification Number: https://doi.org/10.1136/emermed-2017-206717
ISSN: 1472-0205
URI: http://sure.sunderland.ac.uk/id/eprint/13094
Official URL: http://dx.doi.org/10.1136/emermed-2017-206717

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Date Deposited: 29 Jan 2021 15:52
Last Modified: 29 Jan 2021 15:52

Contributors

Author: Tony Kyle
Author: Ian Greaves
Author: Anthony Benyon
Author: Vicky Whitaker
Author: Jason Smith
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Faculty of Health Sciences and Wellbeing > School of Nursing and Health Sciences

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