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The plasma total calcium concentration is in the range of 2.2–2.6 mmol/L (9–10.5 mg/dL), and the normal ionized calcium is 1.3–1.5 mmol/L (4.5–5.6 mg/dL). [4] The amount of total calcium in the blood varies with the level of plasma albumin, the most abundant protein in plasma, and therefore the main carrier of protein-bound calcium in the blood.
In whole blood (g/cm 3) In plasma or serum (g/cm 3) ... Maintain calcium and phosphorus levels ... Calcium: Bones, Ca 2+ ionized
The US Institute of Medicine (IOM) established Recommended Dietary Allowances (RDAs) for calcium in 1997 and updated those values in 2011. [6] See table. The European Food Safety Authority (EFSA) uses the term Population Reference Intake (PRIs) instead of RDAs and sets slightly different numbers: ages 4–10 800 mg, ages 11–17 1150 mg, ages 18–24 1000 mg, and >25 years 950 mg. [10]
Circuit primed with red cells or reconstituted whole blood. [3] [8] Citrate Toxicity: Experienced when ionized calcium levels are low due to citrate anticoagulation which binds to free calcium in the blood, resulting in hypocalcemia. [1] [2] [6] [9] [10] Pediatric considerations to reduce incidences [spelling?] of citrate toxicity:
Physiologically, blood calcium is tightly regulated within a narrow range for proper cellular processes. Calcium in the blood exists in three primary states: bound to proteins (mainly albumin), bound to anions such as phosphate and citrate, and as free (unbound) ionized calcium. Only the unbound ionized calcium is physiologically active. Normal ...
Calcium deposits known as limbus sign may be visible in the eyes. [7] Symptoms are more common at high calcium blood values (12.0 mg/dL or 3 mmol/L). [6] Severe hypercalcaemia (above 15–16 mg/dL or 3.75–4 mmol/L) is considered a medical emergency: at these levels, coma and cardiac arrest can result.
The second homeostatic mechanism, with its sensors in the thyroid gland, releases calcitonin into the blood when the blood ionized calcium rises. This hormone acts primarily on bone, causing the rapid removal of calcium from the blood and depositing it, in insoluble form, in the bones. [63]
Calcium is also required at other points in the coagulation cascade. Calcium ions play a major role in the regulation of coagulation cascade that is paramount in the maintenance of hemostasis. Other than platelet activation, calcium ions are responsible for complete activation of several coagulation factors, including coagulation Factor XIII. [43]