AngelaCondie Posted January 12, 2016 Share Posted January 12, 2016 In preemies, do you start calcium in the IV right away? How much? Do you have a problem with calcium infiltration of the skin? We have used D10 for the first day, then switch to D1/5. If they are still not tolerating feeds by the third day, we add KCl. When should we add calcium? Should we use D1/2 instead? Thanks Link to comment Share on other sites More sharing options...
Mohan Posted February 1, 2016 Share Posted February 1, 2016 On 1/12/2016 at 6:18 AM, AngelaCondie said: In preemies, do you start calcium in the IV right away? How much? Do you have a problem with calcium infiltration of the skin? We have used D10 for the first day, then switch to D1/5. If they are still not tolerating feeds by the third day, we add KCl. When should we add calcium? Should we use D1/2 instead? Thanks Link to comment Share on other sites More sharing options...
yalsaba Posted February 1, 2016 Share Posted February 1, 2016 Start Calcium in the first day but only in central line. Calcium should not be given through peripheral line.. Link to comment Share on other sites More sharing options...
Stefan Johansson Posted February 1, 2016 Share Posted February 1, 2016 Hi @AngelaCondie - we always consider the risk of hypocalcemia as well and always follow s_ca (we get this on our blood gases). Unless the baby is "near-term" (say 33-36 weeks, and we aim for enteral feeding only), we use our "standard-TPN"-bags. The calcium content typically gives 0.5 mmol/kg the first day and we soon reaches 1 mmol/kg/d which we aim for as the normal amount. If needed we also add ~0.5 mmol Ca/kg/d, in a central line. Link to comment Share on other sites More sharing options...
Stefan Johansson Posted February 1, 2016 Share Posted February 1, 2016 I add some more input here: We may consider peripher veins too but then always together with the regular fluid (usually glucose). The tricky question is when calcium is really-really needed… I am not sure it is always needed when we give it. Typically we treat a lab value. Here we let S-ca (free) go below 1.0 mmol/L before we do anything if the baby is reasonable well. Further, the calcium ions move in/out cells depending on pH, so for example, if a baby is instable with breathing /resp support, calcium can change up/down without us knowing more than the glimpse we get when we take the sample. Link to comment Share on other sites More sharing options...
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