Variation in serum ionized calcium on cardiopulmonary resuscitation.

Changes in serum ionized calcium (Ca(++)) levels during cardiopulmonary resuscitation (CPR) and before and after CaCl(2) administration have been examined and investigated in 30 patients with cardiopulmonary arrest on arrival (dead on arrival patients) when a significant negative correlation was found to exist between the transportation time and aCa(++), as the aCa(++) level decreased with an increase in the transportation time. Upon arrival, the pH had fallen due to acidosis so that aCa(++) and cCa(++) levels were virtually normal. After admission, the pH rose as a result of CPR, resulting in a significant drop in both Ca(++) levels, so that in most cases resuscitation was not possible. Those successfully resuscitated took over 60 min to return to normal Ca(++) levels. Administration of approximately 6.6 mg/kg of CaCl(2) led to significant increases in aCa(++) and cCa(++) to essentially normal levels, even with some patients recording extremely elevated Ca levels, even with some patients recording extremely elevated Ca levels. However, the success rate of resuscitation was not found to show any significant difference according to whether CaCl(2) had or had not been administrated.Thus, it is felt necessary to re-examine the use of calcium chloride on CPR.