• Zoel A Quiñónez, Alexandra Klein, Xi Li, Michael Andrew Lennig, Andrew James Giustini, Madalane G Boltz, and Danton Char.
• Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA. Electronic address: zoelq@stanford.edu.
• J. Cardiothorac. Vasc. Anesth. 2024 Nov 1; 38 (11): 263626422636-2642.

ObjectivesTo determine if bolus administration of calcium increases pulmonary artery pressures after unifocalization procedures or pulmonary artery reconstruction surgery.DesignRetrospective cohort study using Stanford University's data warehouse.SettingA large pediatric heart center within an academic quaternary care facility.ParticipantsAll patients undergoing pulmonary artery reconstruction or unifocalization procedures identifiable in the data warehouse.InterventionsData were collected from Stanford University's data repository and formatted and analyzed using RStudio (v 2023.06.1+524).Measurements And Main ResultsThe primary outcome was the change in pulmonary artery systolic pressure (PASP) after a bolus administration of calcium. Secondary endpoints include changes in pulmonary arterial-to-systemic arterial pressure ratio, mean arterial pressure, right-sided filling pressure, and left atrial pressure. The Friedman test was used to assess differences and the Durbin-Conover rank-sum for pairwise comparisons. A difference in PASP after a bolus dose of calcium was found (Friedman X2 = 13.67, p = 0.003), with a higher PASP 5 minutes after calcium administration compared with 2 minutes before administration (35 mmHg v 33 mmHg, p = 0.01), and a higher PASP 10 minutes after calcium administration compared with2 minutes before administration (35 mmHg v 33 mmHg, p = 0.008).ConclusionsCalcium bolus administration led to an increase in pulmonary arterial pressure in patients after pulmonary artery reconstruction or unifocalization surgeries. It may be prudent to avoid bolus administration in this patient population immediately after repair or in patients with right ventricular dysfunction.Copyright © 2024 Elsevier Inc. All rights reserved.

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