[Influence of ionized calcium concentration during cardiopulmonary bypass on pediatric cardiac surgery].

Changes of serum ionized calcium concentration (Ca2+) during cardiopulmonary bypass (CPB) were analyzed in 30 pediatric cardiac patients less than 15 kg body weight. Ca2+ decreased suddenly after the start of CPB, and it gradually increased to the normal value. Citrate added to the stored blood for priming and its metabolism might play a role in these changes of Ca2+. Addition of adequate volume of calcium chloride to the priming prevented sudden decrease of Ca2+. Although addition of citrate before aortic declamp effectively decreased Ca2+ and may prevent reperfusion cardiac injury associated with hypercalcemia, there were no correlation between predeclamp level of Ca2+ and serum CPK and GOT levels.