Is Calcium Beneficial or Deleterious in Patients with Cardiac Arrest?

Editorials15 July 1988Is Calcium Beneficial or Deleterious in Patients with Cardiac Arrest?Arnold M. Katz, MDArnold M. Katz, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-109-2-91 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMore than 50 years ago, Chambers and Reznikoff (1) noted that amoebae placed in water containing only sodium chloride or potassium chloride became sluggish, rounded up, and eventually died. Normal activity was restored when calcium chloride was added outside the cell, but injection of calcium chloride into the cell caused the cytoplasm to contract and solidify. Similar opposing effects of calcium are seen in the heart. Small amounts of extracellular calcium are essential for contraction, whereas an excessive rise in intracellular calcium causes cardiac cell death (2). Because calcium can be both essential and detrimental, it is not difficult to...References1. ChambersReznikoff RP. Micrurgical studies in cell physiology. I. The action of the chlorides of Na, K, Ca, and Mg on the protoplasm of amoeba proteus. J Gen Physiol. 1926;8:369-401. CrossrefMedlineGoogle Scholar2. KatzReuter AH. Cellular calcium and cardiac cell death [Editorial]. Am J Cardiol. 1979;44:188-90. CrossrefMedlineGoogle Scholar3. HarrisonAmey EB. Use of calcium in electromechanical dissociation. Ann Emerg Med. 1984; 13(9 pt 2):844-5. CrossrefMedlineGoogle Scholar4. StuevenThompsonAprahamianDarin HBCJ. Use of calcium in prehospital cardiac arrest. Ann Emerg Med. 1983;12:136-9. CrossrefMedlineGoogle Scholar5. StuevenThompsonAprahamianTonsfeldtKastenson HBCDE. The effectiveness of calcium chloride in refractory electromechanical dissociation. Ann Emerg Med. 1985;14:626-9. CrossrefMedlineGoogle Scholar6. StuevenThompsonAprahamianTonsfeldtKastenson HBCDE. Lack of effectiveness of calcium chloride in refractory asystole. Ann Emerg Med. 1985;14:630-2. CrossrefMedlineGoogle Scholar7. StempienKatzMessineo AAF. Calcium and cardiac arrest. Ann Intern Med. 1986;105:603-6. LinkGoogle Scholar8. Finn M. Calcium and cardiac arrest [Letter]. Ann Intern Med. 1987;106:630-1. LinkGoogle Scholar9. KayBlalock JA. The use of calcium chloride in the treatment of cardiac arrest in patients. Surg Gyn Obstet. 1951;93:97-102. MedlineGoogle Scholar10. Standards for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC). JAMA. 1974;227(Suppl):833-68. MedlineGoogle Scholar11. Standards for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC). JAMA. 1980;244:453-509. CrossrefMedlineGoogle Scholar12. Katz A. Potential deleterious effects of inotropic agents in the therapy of heart failure. Circulation. 1986;73(3 pt 2): 184-90. Google Scholar13. Katz A. Biochemical "defect" in the hypertrophied and failing heart: deleterious or compensatory? Circulation. 1973;47:1076-9. CrossrefMedlineGoogle Scholar14. Katz A. A new inotropic drug: Its promise and a caution [Editorial]. New Engl J Med. 1978;299:1409-10. CrossrefMedlineGoogle Scholar15. Dembo D. Calcium in advanced life support. Crit Care Med. 1981;9:358-9. CrossrefMedlineGoogle Scholar16. Standards and guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC): Part III. Adult advanced cardiac life support. JAMA. 1986;255:2933-54. Google Scholar17. UrbanScheideggerBuchmannBarth PDBD. Cardiac arrest and blood ionized calcium levels. Ann Intern Med. 1988;109:110-13. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of Connecticut Farmington, Connecticut PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTotal Synthesis of Robustaflavone, a Potential Anti-Hepatitis B AgentNew Whole Blood Analyzers and Their Impact on Cardiac and Critical CareCardiopulmonary ResuscitationIonized hypocalcemia during prolonged cardiac arrest and closed-chest CPR in a canine modelPharmacological treatment of asystole and electromechanical dissociationDisorders of Calcium and Magnesium Metabolism 15 July 1988Volume 109, Issue 2Page: 91-92KeywordsCalciumChloridesCytoplasmHeartPotassium chlorideSodium chloride Issue Published: 15 July 1988 PDF downloadLoading ...