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TREATMENT OF HYPERKALAEMIA IN THE NEONATE
- Muhammad S. Furqan (Ireland)
Abstract
Background and Aims
Hyperkalaemia is more common in extremely low birth weight infants and is associated with high mortality in the neonatal population. We aimed to systematically review literature on the treatment of hyperkalaemia in neonates.
Methods
A peer reviewed search was conducted using Embase, Pubmed and Cochrane databases according to PRISMA guidelines. The search identified literature on therapeutic interventions for the treatment of hyperkalaemia in newborns (≤ 4 weeks of life). Data was extracted on study design, sample size, patient demographics, primary treatments and adjunctive treatments, and outcomes.
Results
A total of 519 titles were identified with 67 texts for full paper review. A final 10 articles met our inclusion criteria. Primary treatments that were identified included salbutamol, glucose/insulin infusion, potassium exchange resins and peritoneal dialysis. Adjunctive treatments included sodium bicarbonate and calcium gluconate. All 5 treatment methods identified showed efficacy in the reduction of serum potassium levels in neonates. Nebulized salbutamol demonstrated superior efficacy and safety in comparison to other treatments in multiple studies. Hyperkalaemia associated with congenital endocrine disorders, including congenital adrenal hyperplasia and pseudohypoaldosteronism, was also reported. Treatment involved the use of hydrocortisone and fludrocortisone in conjunction with standard treatment methods.
Conclusions
Improved insight into the aetiology of hyperkalaemia would assist in planning optimal management to improve outcomes.