Interventions for non-oliguric hyperkalaemia in preterm neonates

Vemgal, Prakash; Ohlsson, Arne

doi:10.1002/14651858.cd005257

Cited by 10 publications

(24 citation statements)

References 26 publications

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“…5,9 Recent meta-analyses found that insulin and glucose might provide benefit compared with rectal Kayexalate, but the results were only borderline statistically significant. 12 The effect of salbutamol was investigated in 11 children with endstage chronic renal failure. 8 They showed that an intravenous infusion of salbutamol caused a decrease in mean SK concentration by 0.87 and 0.28 mmol/L at 30 and 60 minutes, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…6.5 mmol/L in two nonhemolyzed venous or arterial blood samples. 12 Treatment was considered successful if SK decreased below 7 mmol/L after the treatment. Treatment discontinued when SK levels became < 6 mmol/L for two readings (normal SK).…”

Section: Methodsmentioning

confidence: 99%

“…3 The observed salbutamolinduced decrease in SK is a result of stimulation of the membrane-bound NA þ /K þ ATPase by a mechanism that involves the B-adrenoreceptor. 11 In a recent systematic review on NOHK, Vemgal and Ohlsson 12 found limited information from small studies of uncertain quality and thus could not make any firm recommendation for clinical practice. Although it has been used in increasing number of neonatal units, up to now there is no conclusive evidence that salbutamol is effective in treating preterm infants with NOHK, and controlled data are urgently needed.…”

mentioning

confidence: 99%

“…Although it has been used in increasing number of neonatal units, up to now there is no conclusive evidence that salbutamol is effective in treating preterm infants with NOHK, and controlled data are urgently needed. 12 In our unit since June 2002, salbutamol infusion has been introduced as the principal therapy for preterm infants with NOHK. Before that date, cation-exchange resin (Kayexalate) enema was the basic therapy for preterm hyperkalemia.…”

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confidence: 99%

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Salbutamol Versus Cation-Exchange Resin (Kayexalate) for the Treatment of Nonoliguric Hyperkalemia in Preterm Infants

Yaseen

Khalaf²,

Dana³

et al. 2008

Amer J Perinatol

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Our objective was to compare the efficacy and safety of rectal cation-exchange resin (Kayexalate) versus salbutamol infusion for the treatment of nonoliguric hyperkalemia (NOHK) in preterm infants. Data of all neonates born with NOHK during the study period of 6 years and 8 months were recorded. Diagnostic criteria of NOHK included serum potassium (SK) concentration > or = 7 mmol/L during the first 72 hours of life with urine output > or = 1 mL/kg/hour. This before-after study was divided according to the date of admission; the first 15 patients were treated with Kayexalate enema 1 g/kg every 4 hours, and the remaining 30 patients were treated with intravenous salbutamol infusion as 4 mug/kg every 4 hours. Treatment discontinued when SK became < 6 mmol/L. SK was measured every 4 hours. Daily urine was collected. Fluid intake and output, serum electrolytes, urea, creatinine, and glucose concentrations were obtained in all infants every 12 hours. All infants were observed with a cardiorespiratory monitor and oxygen saturation and blood pressure measurements. Perinatal characteristics in both groups were comparable. Mean gestational age was 26 and 28 weeks for salbutamol and Kayexalate, respectively. The peak of SK ranged between 7 and 9.3 mmol/L in the Kayexalate group and between 7 and 8.7 mmol/L in the salbutamol group ( P = 0.64). At 12 hours of treatment, SK became normal in only 4 patients (26%) in the Kayexalate group compared with 18 patients (60%) in the salbutamol group ( P = 0.003). The number of doses of Kayexalate administration was significantly higher than the doses of salbutamol ( P = 0.003). No significant side effects were detected in the salbutamol-treated infants. In contrast, there were two cases of severe ventricular tachycardia and one case of intestinal obstruction in the cation-exchange resin group. We concluded that salbutamol infusion is more effective with faster action and safer than cation-exchange resin (Kayexalate) for the treatment of NOHK in preterm infants.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Salbutamol Versus Cation-Exchange Resin (Kayexalate) for the Treatment of Nonoliguric Hyperkalemia in Preterm Infants

Yaseen

Khalaf²,

Dana³

et al. 2008

Amer J Perinatol

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“…Vemgal and Ohlsson performed a meta-analysis on the reported comparative interventions for nonoliguric hyperkalemia in preterm neonates. 42 Serum potassium levels declined at 4 hours (weighted mean difference [WMD] ¼ À 0.69 mmol/l) and 8 hours (WMD ¼ À 0.59 mmol/L) in the salbutamol group. Malone 43 compared a glucose þ insulin to a cation-exchange resin strategy in 12 very low-birth-weight infants, in favor of glucose þ insulin and a similar study has been performed by Hu et al 44 in 40 preterm infants.…”

Section: Comparative Studiesmentioning

confidence: 99%

Bronchodilator and Antihyperkalemic Effects of Salbutamol (Albuterol) in Neonates and Young Infants

Pacifici

Allegaert

2016

J Pediatr Biochem

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Salbutamol (albuterol) is a ?2-agonist used for its bronchodilator activity and for its antihyperkalemic property. Salbutamol was specifically designed for use in infants and children. The preferred route of administration is by a nebulizer because systemic effects are lower than after oral or intravenous administration. Salbutamol is the most widely used bronchodilator in adults and children. When inhaled from metered-dose aerosol, it is easy to use, has a rapid onset of action, and does not have significant adverse effects. Compared with preadministration values, salbutamol yields a significant decrease in resistance and an increase in compliance. Salbutamol can alleviate bronchospasm in infants and children with chronic lung disease such as asthma. The bronchodilator effects of salbutamol are attributed to the R-enantiomer of salbutamol (levosalbutamol). The decrease in airway resistance reflects the relationship between the bronchial smooth muscle and the diameter of the airways. Infants who required intubation and mechanical ventilator support for respiratory syncytial virus-induced respiratory failure had an improvement of lung function following the administration of salbutamol. Nebulized salbutamol has not been reported to have cardiac side effects. Epinephrine was not found to be more efficacious than salbutamol in treating moderately ill infants with bronchiolitis. Hyperkalemia is a fatal disorder that requires treatment. The aim of this review is to summarize the published data on the activities of salbutamol as a bronchodilator and as an antihyperkalemia agent in neonates.

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Intrapulmonary drug administration in neonatal and paediatric critical care: a comprehensive review

Donn¹

2011

Yearbook of Neonatal and Perinatal Medicine

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Interventions for non-oliguric hyperkalaemia in preterm neonates

Cited by 10 publications

References 26 publications

Salbutamol Versus Cation-Exchange Resin (Kayexalate) for the Treatment of Nonoliguric Hyperkalemia in Preterm Infants

Salbutamol Versus Cation-Exchange Resin (Kayexalate) for the Treatment of Nonoliguric Hyperkalemia in Preterm Infants

Bronchodilator and Antihyperkalemic Effects of Salbutamol (Albuterol) in Neonates and Young Infants

Intrapulmonary drug administration in neonatal and paediatric critical care: a comprehensive review

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