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April 19, 2026Journal of Trauma and Acute Care Surgery

Aggressive calcium chloride dosing reduces early mortality in trauma patients receiving whole blood resuscitation

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Authors

ARAashish RajeshLBLauran BarryDLDavid Limón

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Overview

Retrospective cohort study evaluates calcium dosing's effect on 24-hour mortality in trauma patients, suggesting better survival outcomes with adequate supplementation.

Key Points

  • This study aims to assess the impact of calcium chloride dosing on early mortality in trauma patients receiving whole blood resuscitation.
  • Conducted a retrospective single-center cohort study from 2020 to 2023.
  • Included trauma patients receiving low-titer O whole blood and calcium within 4 hours of arrival.
  • Collected data on demographics, injury mechanisms, Injury Severity Score, transfusion volumes, and calcium administration.
  • Analyzed calcium supplementation as a continuous variable and using mutually exclusive ranges.
  • Twenty-four-hour mortality was observed in 13.6% of patients.
  • Calcium chloride dosing of ≥1 g per 2 units of whole blood significantly reduced 24-hour mortality by 84%.
  • The association of calcium chloride near significance was noted for patients receiving ≥2 units of whole blood.
  • Gluconate showed no significant mortality benefits in this cohort.

Cite This Study

Rajesh et al. (2026) studied this question.

synapsesocial.com/papers/69e473de010ef96374d8f9b3https://doi.org/10.1097/ta.0000000000005009
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Early calcium replacement after minimal blood transfusion is associated with adverse outcomes2026
  2. 2Mapping ionized calcium levels and evaluating the outcome of prehospital calcium supplementation in acute trauma and hemorrhagic shock2026 · 1 citations
  3. 3Pre-Hospital Calcium Administration Reduces Incidence of Hypocalcemia and Mortality in Trauma Patients2026 · 1 citations
  4. 4Calcium supplementation during trauma resuscitation: a propensity score-matched analysis from the TraumaRegister DGU®2024 · 13 citations
  5. 5Ratios of calcium to citrate administration in blood transfusion for traumatic hemorrhage: A retrospective cohort study2024 · 10 citations