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INTESTINAL NECROSIS AND PERFORATION CAUSED BY INTRAARTERIAL CALCIUM GLUCONATE INFUSION

The umbilical artery catheter is frequently utilized as a route for administration of medication in the premature infant. The effect of intra-arterially administered calcium gluconate (Ca Gluc) on the intestine was studied in the rabbit by injecting 1 cc of 10% Ca Glue, 1% Ca Gluc, or saline into a first order arterial arcade supplying approximately a 10 em segment of ileum. All animals receiving Ca Gluc demonstrated varying periods of vasodilatation following the injection. Rabbits were sacrificed Between 3 and 6 days and the gross and histologic findings compared for saline and Ca Glue injected rabbits:All animals"receiving 10% Ca Gluc showed mucosal atrophy with 3/6 having perforation and 1/6 with mucosal hemorrhage. 3/5 animals receiving 1% Ca Gluc showed mucosal atrophy. Intra-arterial infusion of Ca Gluc in the usual therapeutic doses and concentrations administered to premature infants produced serious intestinal injury characterized by mucosal atrophy, depressed mitotie index and intestinal perforation.