Hypocalcemia

 Serum calcium level less than 7mg/dl

Early onset neonatal hypocalcemia:

Seen in preterm < 32 weeks, diabetic mother, maternal hyperparathyroidism

Late onset hypocalcemia:

Born to mothers (with Vitamin D deficiency, on antiepileptics)

Clinical features:

  Neurological: Myoclonic jerks, jitteriness, exaggerated startle and seizures. 

  Cardiac: tachycardia, heart failure (cardiomyopathy induced), prolonged QT interval, decreased contractibility.

Treatment for symptomatic ones:

  Bolus dose: 2ml/kg/dose

  IV infusion of 80mg/kg/day elemental calcium for 48 hours, 50% dose in next 24 hour.

  Preventive dose: 4 ml/kg/ day of 10% calcium gluconate.