Calcium and the anaesthetist

Calcium plays a central role in a large number of physiological actions tha t are essential for life. It is important therefore that the anaesthetist u nderstands calcium pathophysiology. In this review, the physiology, regulat ion, clinical features, causes and treatment of alterations in circulating calcium will be discussed. In addition, the effects that acid-base status, massive blood transfusion and cardiopulmonary bypass may have on circulatin g calcium will be highlighted. Finally, the role that calcium plays in isch aemic/reperfusion injury and myocardial stunning will be summarised.