Hypocalcemia in Neonates

Ira Shah
Hypocalcemia in Neonates - Treatment
Calcium gluconate (10% solution) is given IV at 1-2 ml/kg (100 mg/kg) slowly to treat symptomatic hypocalcemia. IV calcium should be given slowly as rapid infusion can cause sudden elevation of serum calcium level causing bradyarrythmias. Also care should be taken to prevent subcutaneous extravasation as it may cause severe necrosis and subcutaneous calcifications. Maintenance therapy is given at 200 mg/kg/day IV and increased as needed to maintain serum calcium level at 7 to 8 mg/dl.

Therapy should be then initiated for specific cause of hypocalcemia. Intractable hypocalcemia due to hypomagnesemia is treated with Magnesium Sulphate (0.2ml/kg of 50 % solution or 0.4 ml/kg of 25% solution) intramuscularly or intravenously. Hypocalcemia associated with hyperphosphatemia is treated by giving the infants a low phosphorous formula or human milk and adding calcium supplements to the milk. Infants with vitamin D deficiency are treated with oral Vitamin D analogues (dihydrotachysterol and calcitriol).

Hypocalcemia in Neonates Hypocalcemia in Neonates 01/08/2003
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