Background. Late transient neonatal
hypocalcemia with
hyperphosphatemia is potentially life-threatening. The use of 1.25 dihydroxycholecalciferol in the management of neonatal
hypocalcemia is unexplored. Objective. We hypothesized adding 1.25 dihydroxycholecalciferol to intravenous continuous
calcium infusion (CaI) will achieve accelerated correction of
hypocalcemia. Design/Methods. A controlled double-blind randomized placebo group was organized to compare the addition of 1.25 dihydroxycholecalciferol to CaI in 3-14 day old neonates presenting with
hypocalcemia,
hyperphosphatemia and
seizures. Ionized
calcium and
phosphorus were measured to adjust CaI and maintain eucalcemia. Time to resolution of
hypocalcemia was defined as time from starting CaI to the first ionized
calcium of >/=1.1 mmol/L. CaI was discontinued when ionized
calcium levels were >/=1.1 mmol/L on two measurements and the infant tolerated feeds. Results. Fourteen neonates were studied without statistical difference between groups. Time to correction of
hypocalcemia for
1,25 dihydroxycholecalciferol versus placebo was 7.2 +/- 1.9 versus 11.5 +/- 3.4 hours respectively (p = .26). The duration of CaI was 15.0 +/- 1.5 versus 24.8 +/- 4.4 hours respectively (p = .012). Conclusions. The addition of 1.25 dihydroxycholecalciferol to standard CaI
therapy reduced the duration of CaI, but did not reduce the time to correct
hypocalcemia in neonates with late transient
hypocalcemia.