Table 2.

Initial infusion rate (ml/h) of 136 mM CaCl2 in 0.9% saline for goal systemic ionized Ca 1.15 mM

Effluent Flow Rate (ml/hr)0.0–0.7 g/dl0.8–1.2 g/dl1.3–1.7 g/dl1.8–2.2 g/dl2.3–2.7 g/dl2.8–3.2 g/dl3.3–3.7 g/dl3.8–4.2 g/dl4.3–4.7 g/dl4.8–5.2 g/dl
≤210028293031323233343536
2101–2500a34353637383940414243
2501–285039414243444547484950
2851–325045474850515253555557
3251–365051525456575860616264
3651–4000a56586062636567686971
4001–440062646668697173757678
4401–475068707274767880828385
4751–515072747779818385878991
5151–550076788184858890929497
5501–5850a798285879092949799101
  • In patients with citrate metabolism presumed absent, the initial QCa is chosen from Table 2 on the basis of the systemic albumin level and the total effluent flow rate (≈QACDA+QD+QRF). The effect of any net ultrafiltration on QCa can be neglected. Precalculated, plasma clearance-based Ca-infusion dosing is largely independent of the intake blood Hct level if the systemic hemoglobin (Hb) <14 g/dl and the fixed post-CVVHDF-RCA flow settings are selected from Table 1. To target a higher systemic iCa of 1.3 mM (at the ICU team’s discretion) the initial Ca-infusion rate derived from Table 2 can be multiplied by 1.13. QCa, calcium infusion rate; QACDA, acid citrate dextrose anticoagulant infusion rate; QD, dialysate flow rate; QRF, replacement fluid flow rate.

  • a Patients included in this study were treated using one of these rows.