I assume you mean citrate, not lactate (?see your subject line). Actually,
both of these will bind calcium ions and therefore decrease ionized calcium.
The effect of citrate on ionized calcium is much more profound than on total
calcium. During liver transplantation (particularly the anhepatic phase of
the operation), citrate from the transfused blood is not metabolized,
accumulates, and binds calcium ions. Patients frequently require calcium
supplementation and perioperative ionized calcium measurements are critical
to monitor for ionized hypocalcemia. Total calcium measurements will be
totally misleading and may actually indicate hypercalcemia!
[See the following references: (1) Gray TA et al, Transplantation
1986;41:335. (2) Wu AHB et al, Arch Pathol Lab Med 1987;111:935. (3) Kost
GJ et al, Am J Clin Pathol 1986;86:81.]
Sal Sena
Danbury Hospital
Danbury, CT USA
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From: Bharatkumar H Patel
To: [log in to unmask]
Subject: lactate
Date: Thursday, December 03, 1998 11:39AM
<bigger><bigger>Can anyone tell me the effect of citrate on calcium.
I know total calcium drops. But what happens to
ionized calcium?
What is the effect on calcium during liver
transplantation with transfusion?
Bharat<smaller><smaller>
<nofill>
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