[kafo]

I am looking for any information on IV calcium replacement for therapeutic plasma exchange. Currently we are supplementing with CaCl 1gm/250 mls starting at 50-75 ml/hr and increasing if pt shows signs of hypocalcemia. I have researched the topic and can not find any solid protocols.
If you have any links to information i would appreciate it.
Thanks

[BlevinsRN]

With our plasmapheresis treatments, we do a continuous calcium gluconate infusion throughout the whole treatment. We do 10 ml of calcium gluconate(sorry I can't remember the concentration at this time) per 1000ml of the remove volume of plasma. For example, if we are removing 3200 ml of plasma, we would mix 32 ml of calcium gluconate into a 250ml bag of 0.9% NS and calculate the rate to coincide with the length of the treatment. I have been taught that if the patient becomes very symptomatic, you should pause the treatment. This is the quickest way that you can relieve the symptoms because the citrate that is causing the hypocalcemia metabolizes very quickly and will begin to wear off once you pause the treatment and they quit receiving the citrate. Hope this helps!