Calcium gluconate 544mg/5ml / Calcium lactate 276mg/5ml oral solution

IntroductionIntravenous (IV) fluid therapy plays a vital role in modern medical practice, particularly in critical care management. This review aims to summarize the composition, indications, and contraindications of IV fluids, serving as a useful resource for healthcare professionals.MethodsReview of the literature published in MEDLINE using PubMed and Web of Science, between 2009 and 2024. Systematic reviews, meta-analyses, expert reviews, and guidelines were preferred for analysis.ResultsIV fluids can be administered for various reasons, including resuscitation, correction of electrolyte imbalances, or more critical cases. They can be divided into 2 categories: crystalloids and colloids. Crystalloids, in turn, can be subdivided into unbalanced solutions, such as salines (0.45%, 0.9%, 3%, and 20%) and dextrose 5%, or balanced solutions, such as Ringer lactate and polyelectrolytic solutions. Colloids can be derived from plasma, such as 5% albumin, or semisynthetic, such as 4% modified fluid gelatin. Crystalloids are generally more cost-effective, have a lower risk of allergic reactions, and are more readily available than colloids. However, the use of each solution should be individualized based on the patient's specific needs and corresponding conditions.ConclusionsIt is essential to have a thorough understanding of available IV fluid solutions to select the best option for each patient's condition at any given time. This review summarizes the most relevant information to guide these decisions. Future research should develop IV fluids that combine the benefits of colloids and crystalloids for safer, more personalized, and cost-effective treatments.

Abstract licence: CC BY-NC-ND

BackgroundHypoparathyroidism (HypoPT) is a rare endocrine disorder characterized by insufficient or absent secretion of parathyroid hormone (PTH), which results in hypocalcemia, hyperphosphatemia, and disruption of calcium phosphate homeostasis. Despite advances in understanding its pathophysiology and management, HypoPT remains a complex and impactful condition associated with significant morbidity, impaired quality of life, and long-term complications affecting the skeletal, renal, and neurological systems.MethodsA literature search was performed on PubMed. Articles were selected based on their relevance to the main topic of the review, with particular attention to recent studies.ResultsThis review provides a comprehensive synthesis of the current knowledge on HypoPT, addressing its epidemiology, underlying pathophysiological mechanisms, genetic and acquired etiologies, clinical manifestations, diagnostic strategies, and chronic disease-related complications. Emphasis is placed on the genetic spectrum of the disease, challenges of postsurgical management, and burden of conventional therapy, which often fails to fully restore mineral homeostasis and patient well-being. The evolving therapeutic landscape is detailed, highlighting advances from traditional calcium and active vitamin D supplementation to innovative PTH replacement strategies. Among these, palopegteriparatide and eneboparatide (phase 3 clinical trial ongoing) are reshaping treatment paradigms by enabling more physiological restoration of calcium-phosphate balance, reducing complications, and improving patient-centered outcomes, including renal function and quality of life.ConclusionsBy integrating clinical expertise with the latest research developments, this review offers an updated and holistic perspective on HypoPT management, aiming to support clinicians in delivering effective and individualized care to patients across the spectrum of disease severity.

Abstract licence: CC BY-NC-ND

Calcium plays an essential role in myocardial contractility, excitation-contraction coupling, and vascular tone. In cardiothoracic surgery, calcium supplementation is frequently administered during weaning from cardiopulmonary bypass (CPB) and in the early postoperative period to support haemodynamics. Despite its widespread use, the evidence base underpinning this practice remains limited and inconsistent. This narrative review explores the physiological rationale for calcium supplementation in the cardiothoracic surgical population, synthesises existing experimental and clinical data, and considers potential benefits and risks relevant to contemporary intensive care practice. Animal models suggest that calcium desensitisation contributes to myocardial dysfunction following hypothermic circulatory arrest, with supplementation theoretically improving contractility. In human studies, calcium administration during CPB weaning or in the immediate post-CPB period has been associated with transient increases in mean arterial pressure, systemic vascular resistance and left ventricular stroke work index. However, these effects are short-lived and data beyond the early postoperative phase remains limited. Potential risks of calcium supplementation include exacerbation of ischaemia-reperfusion injury, arrhythmogenesis, graft vasospasm, and tissue injury related to extravasation. The absence of specific guideline recommendations, in contrast to established consensus for vasopressor therapy, likely contributes to international variability in practice. Most studies are small, dated, or proof-of-concept and no high-quality randomised controlled trials have examined patient-centred outcomes such as vasopressor duration, organ dysfunction, or length of stay. Further multicentre observational and target-trial emulation studies are warranted to clarify the role of ionised calcium use in contemporary perioperative and intensive care practice.

Abstract licence: CC BY