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Neonatal Hypocalcemia : Causes, Symptoms, & Treatment

Neonatal Hypocalcemia : Definition, Etiology, Pathophysiology, Clinical Features, Guidelines, Protocol, Management, PPT

Definition

  • Neonatal Hypocalcemia is defined when Total serum calcium level is <7 mg/dl OR Ionized calcium level is <4 mg/dl.

Types

1. Early onset (If onset within 72 hour of birth)

Causes

  • Prematurity
  • Infant of diabetic mother
  • Maternal hyperparathyroidism

2. Late onset (If onset after 72 hour of birth)

Causes

  • Animal milk diet
  • Malabsorption
  • Neonatal hypoparathyroidism

Clinical Presentation

Early onset : Asymptomatic

Late onset : Asymptomatic or clinical features e.g.

  • Jitteriness
  • Seizures
  • Bradycardia + ECG changes (↑ QTc interval)
  • Irritability
  • Apnea
  • Laryngospasm
  • Tetany

Treatment

If asymptomatic

IV Calcium gluconate infusion (80 mg/kg/dl)     × 48 hours

IV Calcium gluconate infusion (40 mg/kg/dl)     × 24 hours

Stop

If symptomatic

IV Calcium gluconate bolus slow (2 mg/kg over 15-30 minutes after 1:1 dilution)

IV Calcium gluconate infusion (80 mg/kg/dl)     × 48 hours

IV Calcium gluconate infusion (40 mg/kg/dl)     × 24 hours

Stop

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