Anwendung von Kalzium in der Notfallmedizin

Einleitung

Kalziumionen sind an zahlreichen biochemischen Prozessen beteiligt wie z. B. der Gerinnungskaskade, der muskulären Kontraktion und intrazellulären Signalkaskaden mit konsekutiver Sekretion unterschiedlicher Hormone [1].

In der Notfallmedizin steht die intravenöse Anwendung von Kalzium klar im Vordergrund. Die einzige in der jeweiligen Fachinformation [2] [3] der in Deutschland gängigen Präparate aufgeführte Indikation ist die (symptomatische) Hypokalziämie. Darüber hinaus sind weitere Indikationen notfallmedizinisch relevant: die schwere Hyperkaliämie mit EKG-Veränderungen, die Hypermagnesiämie, die Intoxikation mit Kalziumantagonisten, Betablockern und Flusssäure.

Publication History

Article published online:
10 October 2022

• Literatur

• 1 Up to Date. Etiology of hypocalcemia in adults. Accessed June 20, 2022 at: https://www.uptodate.com/contents/etiology-of-hypocalcemia-in-adults
• 2 B. Braun. Fachinformation Calciumgluconat B. Braun 10% Injektionslösung. Accessed June 20, 2022 at: www.fachinfo.de/pdf/002742
• 3 Baxter. Fachinformation Calciumchlorid 5,5% Baxter. Accessed June 20, 2022 at: www.baxter.de/sites/g/files/ebysai1301/files/2019–01/calciumchlorid_55_baxter_fs.pdf
• 4 Up to Date. Treatment of hypercalcemia. Accessed June 20, 2022 at: https://www.uptodate.com/contents/treatment-of-hypercalcemia
• 5 Heining MP, Band DM, Linton RA. Choice of calcium salt. A comparison of the effects of calcium chloride and gluconate on plasma ionized calcium. Anaesthesia 1984; 39: 1079-1082
• 6 Martin TJ, Kang Y, Robertson KM. et al. Ionization and hemodynamic effects of calcium chloride and calcium gluconate in the absence of hepatic function. Anesthesiology 1990; 73: 62-65
• 7 Turner J, Gittoes N, Selby P. et al. Society for Endocrinology Emergency endocrine Guidance: Emergency management of acute hypocalcaemia in adult patients. Endocr Connect 2016; 5: G6-G7
• 8 Anger KE, Belisle C, Colwell MB. et al. Safety of compounded calcium chloride admixtures for peripheral intravenous administration in the setting of a calcium gluconate shortage. J Pharm Pract 2014; 27: 474-477
• 9 Chakraborty A, Can AS. Calcium Gluconate. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021
• 10 Lott C, Truhlar A, Alfonzo A. et al. European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. Resuscitation 2021; 161: 152-219
• 11 Panchal AR, Bartos JA, Cabañas JG. et al. Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142: 366-468
• 12 Up to Date. Primary drugs in pediatric resuscitation. Accessed June 20, 2022 at: https://www.uptodate.com/contents/primary-drugs-in-pediatric-resuscitation
• 13 Van de Voorde P, Turner NM, Djakow J. et al. European Resuscitation Council Guidelines 2021: Paediatric Life Support. Resuscitation 2021; 161: 327-387
• 14 Levine M, Nikkanen H, Pallin DJ. The effects of intravenous calcium in patients with digoxin toxicity. J Emerg Med 2011; 40: 41-46
• 15 Up to Date. Treatment of hypocalcemia. Accessed June 20, 2022 at: https://www.uptodate.com/contents/treatment-of-hypocalcemia
• 16 Doorenbos CJ, Ozyilmaz A, van Wijnen M. Severe pseudohypocalcemia after gadolinium-enhanced magnetic resonance angiography. N Engl J Med 2003; 349: 817-818
• 17 Prince MR, Erel HE, Lent RW. et al. Gadodiamide administration causes spurious hypocalcemia. Radiology 2003; 227: 639-646
• 18 Up to Date. Hypoparathyroidism. Accessed -0 -2, 202 at: https://www.uptodate.com/contents/hypoparathyroidism
• 19 Dichtl A, Vierling W. Inhibition by magnesium of calcium inward current in heart ventricular muscle. Eur J Pharmacol 1991; 204: 243-248
• 20 Graudins A, Lee HM, Druda D. Calcium channel antagonist and beta-blocker overdose: antidotes and adjunct therapies. Br J Clin Pharmacol 2016; 81: 453-461
• 21 McKee D, Thoma A, Bailey K. et al. A review of hydrofluoric acid burn management. Plast Surg 2014; 22: 95-98
• 22 Makarovsky I, Markel G, Dushnitsky T. et al. Hydrogen fluoride-the protoplasmic poison. Isr Med Assoc J 2008; 10: 381-385
• 23 Bentur Y, Tannenbaum S, Yaffe Y. et al. The role of calcium gluconate in the treatment of hydrofluoric acid eye burn. Ann Emerg Med 1993; 22: 1488-1490