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HYPOCALCEMIA:

Calcium is present in three forms:
1 . Protein bound ( 40 %).
2 . Bound to citrate or phosphate ( 10 %).
3 . Ionized:the active part ( 50 %).
Hypocalcemia is defined as serum
calcium < 2 mmol /L ( 8 mg/ dL ) in term or less
than 1.75 mmol /L ( 7 mg/ dL ) in preterm
neonates, or ionized calcium < 4 mg/dl.

- Acidosis results in an increased ionized

calcium and alkalosis decreases it.
Screening for hypocalcemia is indicated in:
1 . Preterm neonates.
2 . I.D.M.
3 . Severe perinatal asphyxia.
Clinical Features:
range from asymptomatic to jitteriness,
tremor of the extremities, tetany,
cardiac arrhythmias, convulsions, apnea
and stridor.

Types of Hypocalcemia:

.Early: 1
within the first 72 hours due to poor feeding
e.g. in RDS, preterm, I.D.M., sepsis.
.Late: 2
at 5 - 7 days up to several weeks due to
transient hypoparathyroidism or
high phosphorus in milk.

TREATMENT:

If convulsions are present give 10 %
calcium gluconate 100 - 200 mg/kg by
i.v. infusion ( 0.2 - 0.5 ml/kg) for three days.

Always watch for extravasation & tissuing

of calcium which may cause skin necrosis.
Oral vit.D 5000 I.U./day should also be given.


رفعت المحاضرة من قبل: Ahmed monther Aljial
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