• Vy A Tran, Evelyn M Griffin, Jehan D Elliott, Rebecca L Scholl, Robert B Hill, Kelbie Kerr, Hala Khan, Jonathan Bates, Xu Zhang, Sepideh Saroukhani, Jorge Salazar, and Olga I Pawelek.
• Division of Pediatric Cardiothoracic Anesthesiology, Department of Anesthesiology, Critical Care and Pain Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX. Electronic address: vy.a.tran@uth.tmc.edu.
• J. Cardiothorac. Vasc. Anesth. 2025 Jan 13.

ObjectivesTo determine if a change from calcium chloride to calcium gluconate infusion resulted in a decreased incidence of atrial thrombi and thrombotic events in neonates undergoing cardiac surgery.DesignA single-center, retrospective cohort analysis.SettingA single center in Houston, TX.Participants135 neonates undergoing cardiac surgery who had either a central venous catheter or tunneled atrial catheter placed and received infusions of either calcium chloride or calcium gluconate in the perioperative period.InterventionsPatients either received a calcium chloride or calcium gluconate infusion in the perioperative period.Measurements And Main ResultsThe study cohort consisted of 93 procedures using calcium chloride and 88 procedures using calcium gluconate infusions. The 181 procedures were recorded on a total of 135 patients. The overall incidence of thrombosis was 9.9%. The association between calcium chloride or calcium gluconate infusion and thrombotic events was assessed using a generalized linear mixed model for binary data (proc Glimmix, SAS v.9.4, SAS Institute, Cary, NC), to account for within-subjects correlation in patients requiring more than one procedure. The odds of thrombotic events when receiving calcium chloride infusion was 3.45 times that with calcium gluconate infusion in the setting of neonatal cardiac surgery (15% v 4.6%, odds ratio = 3.46, 95% confidence interval = 1.02, 11.7, p = 0.047).ConclusionsIn this single-center study, a significant decrease in the odds of an atrial catheter-related thrombus when a calcium gluconate infusion is used instead of calcium chloride was shown.Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.

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