Treatment of hyperkalaemia using intravenous and nebulised salbutamol.

Abstract

In 11 children (aged 5-18 years) with end stage chronic renal failure, the effect on plasma potassium of two doses of salbutamol (separated by two hours) given intravenously (4 ,ug/kg) and on a separate date, of salbutamol administered by nebuliser (2 5 mg ifthe child weighed below 25 kg, 5 mg if above) was observed. Within 30 minutes of the first dose, the mean plasma potassium concentration fell significantly by 0-87 and 0-61 mmol/l after intravenous and nebulised administration respectively. Sixty minutes after the second dose the plasma potassium was significantly reduced by a further 0-28 and 0 53 mmol/l respectively. There was a significant difference between the two methods of administration at 300 minutes after the first dose favouring nebulisation. No major side effects were observed. Nebulised salbutamol should be the first choice emergency treatment ofhyperkalaemia.

Effective treatment of acute hyperkalaemia in childhood by short-term infusion of salbutamol

“…The end product c-AMP stimulates the Na-K-ATPase and induces a shift of K + from the extracellular to the intracellular compartment thereby reducing serum K + levels [3,5]. The K + lowering effect of salbutamol is quite predictable with a mean decrease of 1.6-1.7 mmol/1 after 2 h confirming previous results [9,10]. In these studies the long-term effect was not studied, partly because in 10 of 13 patients investigated by Murdoch et al [10] and in all patients treated by Mc Clure et al [9] dialysis therapy was initiated.…”

“…The K + lowering effect of salbutamol is quite predictable with a mean decrease of 1.6-1.7 mmol/1 after 2 h confirming previous results [9,10]. In these studies the long-term effect was not studied, partly because in 10 of 13 patients investigated by Murdoch et al [10] and in all patients treated by Mc Clure et al [9] dialysis therapy was initiated. In our series 9 of 15 patients required no further K + lowering treatment either because underlying causes were eliminated or renal function recovered.…”

“…This treatment, however, bears the risks of hypoglycaemia, hyperosmolarity, volume overload and unpredictability of response [1,6]. Recently short-term intravenous infusion and inhalation of salbutamol, a selective [32-stimulatory agent has been shown to be an effective treatment of hyperkalaemia in adults [1-4, 7, 8] and children [9,10]. Here we report our results of treating acute hyperkalaemia with intravenous salbutamol in 15 infants and children.…”

In vitro Analysis of the Na⁺-K⁺ ATPase Activity in Neonatal and Adult Red Blood Cells

“…However, the rate of decline in scrum potassium levels is very low, making these agents unsuitable for the therapy of lifethreatening hyperkalemia [7], As a last resort, hemodialysis or double volume exchange transfusion may be used to remove the excess potassium from the serum. Unfortunately, it is technically not feasible to perform dialysis on the smallest of preterm infants, and ex change transfusions have a high associated morbidity [8], Recently there have been re ports that albuterol, a beta: sympathomimet ic agent, lowers the serum potassium level in adults with chronic renal failure [9][10][11][12], Sev eral studies report that albuterol is useful in acutely lowering the serum potassium levels in children with renal failure as well [13][14][15]. This drug has been found effective when ad ministered via either the respiratory or the intravenous route, and is believed to reduce the serum potassium levels by increasing the rate of flux of the cytoplasmic-membraneassociated Na+-K+ ATPase.…”

Hypoxic-ischemic syndrome

“…A hipercalemia, que pode ocorrer em decorrência da insuficiência renal, é tratada com o uso de resinas trocadoras de íons ou salbutamol em infusão endovenosa ou em nebulização 35 .…”