Comparatively Evaluating Medication Preparation Sequences for Treatment of Hyperkalemia in Pediatric Cardiac Arrest

Abstract

Medication preparation for hyperkalemia takes significantly longer for smaller children and preparation of insulin with dextrose takes the longest. This study supports Pediatric Advanced Life Support guidelines to treat hyperkalemia during pediatric cardiac arrest similar to those recommended per Advanced Cardiac Life Support (i.e., first, calcium; second, sodium bicarbonate; and third, insulin with dextrose).

Hypoxaemia and septic shock were independent risk factors for mechanical ventilation in Bangladeshi children hospitalised for diarrhoea

“…The observation of a higher case fatality rate in children with diarrhoea requiring mechanical ventilation was not surprising. Our observation was consistent with a number of previous studies that involved children with diarrhoea who experienced septic shock , hypoxaemia , hypokalaemia and hyperkalaemia and often fatal outcomes.…”

“…It is noteworthy that hypokalaemia and hyperkalaemia were observed to be independent risk factors for mechanical ventilation, even after adjusting for the intake of intravenous fluid during hospitalisation. Although both conditions may present with serious cardiac abnormalities , hyperkalaemia requires emergency management in a critical care ward due to its fatal cardiac toxicity . However, the children in our study with diarrhoea and both conditions required mechanical ventilation, potentially due to cardiac failure.…”

Lebensrettende Maßnahmen bei Kindern (Paediatric Life Support, PLS)

“…In diesem Absatz werden die potenziellen Reversibilitäts- und/oder Behandlungsoptionen bestimmter Pathologien hervorgehoben. Zu diesem Zweck wurden 2 Leitlinien [ 676 , 750 ], ein SR [ 751 ], 8 Beobachtungsstudien und mehrere Übersichtspublikationen identifiziert (Anhang RR 33.1; [ 484 – 486 , 737 , 752 – 755 ]).…”

“…Bezüglich der Hyperkaliämie wird ebenfalls auf das Kapitel "Besondere Umstände" verwiesen. Es wurden ein systematischer Review [482], eine Übersichtsarbeit [483] und 4 Beobachtungsstudien identifiziert (Anhang RR 14.2; [484][485][486][487]). Trotz begrenzter zugrundeliegender Evidenz, insbesondere bei Kindern mit Atem-Kreislauf-Stillstand, ist ein klarer Behandlungsalgorithmus wichtig, um konsistente und wirksame Interventionen sicherzustellen und Dosierungsfehler oder versehentliche Nebenwirkungen zu vermeiden.…”