[The concentration of calcium and its fractions during heart surgery using extracorporeal circulation]. / Kontsentratsiia kal'tsiia i ego fraktsii pri operatsiiakh na serdtse s iskusstvennym krovoobrashcheniem.

Changes in the concentration of calcium and its fractions have been studied in 115 patients subject to standard bypass techniques. It has been found that calcium homeostasis disturbances do really develop and are caused by the use of solutions that are not balanced with blood in their calcium content. The main source of calcium in hemodiluents was gelatinol. A decrease in gelatinol volume to 450-600 ml prevented the onset of marked hypercalcemia. As ionized calcium (Ca2+) concentration is determined not only by the total Ca level, but also by the shifts in the degree of pH- and pCO2-dependent ionization and binding and in ligand and protein content, Ca2+ determination is considered an optimal method of calcium homeostasis control during cardiopulmonary bypass.

[The content of calcium and magnesium in official Soviet solutions used in extracorporeal circulation, anesthesia and resuscitation]. / Soderzhanie kal'tsiia i magniia v ofitsinal'nykh otechestvennykh rastvorakh, primeniaemykh pri iskusstvennom krovoobrashchenii, anestezii i reanimatsii.

Total calcium (CaT) and total magnesium (MgT) levels have been determined in 21 solutions used in cardiopulmonary bypass surgery and manufactured in the USSR. It has been found that a great number of solutions differ in CaT content from human plasma. Some solutions contain Ca, which is not required by the prescription. Even in one and the same lot solutions vary greatly in Ca content (gelatinol). A large number of the solutions tested does not correspond to blood in MgT content, either. Like Ca, this parameter is quite unstable. Such differences in CaT and MgT levels practically in all standard Soviet-made solutions make it impossible to determine accurately precise amount of the solution required. The optimal way of hypercalcemia and hypermagnesiuemia prevention is the elaboration of the solutions identical to blood in their Ca and Mg content, or the use of colloids, practically free of electrolytes (hexaethyl starch).

[The dynamics of parathyroid hormone and calcitonin in surgery with artificial circulation]. / Dinamika paratireoidnogo gormona i kal'tsitonina pri operatsiiakh s iskusstvennym krovoobrashcheniem.

The use of considerable amounts of gelatinol in hypothermal perfusion determined the occurrence of marked hypercalcemia. The hormonal mechanism (parathyroid hormone and calcitonin) responsible for hypercalcemia compensation proved to be inefficient under hypothermal perfusion. A forced diuresis failed to result in rapid normalization of blood calcium concentrations. The volume of gelatinol used during extracorporeal circulation is not to exceed 500 ml.