Efficacy of albuterol inhalation in treatment of hyperkalemia in premature neonates

Singh, Bindya S.; Sadiq, Heena; Noguchi, Akihiko; Keenan, William

doi:10.1067/mpd.2002.125229

Cited by 55 publications

(22 citation statements)

References 28 publications

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“…The low content of Na ϩ -K ϩ -pumps in fetal skeletal muscle reduces the ability to clear K ϩ from plasma and may explain the often marked hyperkalemia in premature children (175,390). Measurements performed on four different pig muscles showed an increase from ϳ500 pmol/g wet wt at birth to ϳ700 pmol/g wet wt within the first week of life, followed by a decline to ϳ300 pmol/g wet wt at 8 wk (100).…”

Section: Growth Differentiation and Fiber Typementioning

confidence: 97%

“…6 and 65). In premature infants, who often develop life-threatening hyperkalemia, treatment with salbutamol intravenously (175) or as inhalation (390) was efficient in reducing plasma K ϩ . Also in normal human subjects the inhalation of salbutamol or fenoterol (another ␤ 2 -agonist) produced dose-dependent hypokalemia, which was a close mirror image of an up to sixfold concomitant increase in the plasma level of cAMP (377), indicating that this second messenger is mediating the effect of ␤ 2 -adrenoceptor stimulation on K ϩ homeostasis also in vivo.…”

Section: B Catecholaminesmentioning

confidence: 99%

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Na⁺-K⁺Pump Regulation and Skeletal Muscle Contractility

Clausen

2003

Physiological Reviews

522

673

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In skeletal muscle, excitation may cause loss of K+, increased extracellular K+ ([K+]o), intracellular Na+ ([Na+]i), and depolarization. Since these events interfere with excitability, the processes of excitation can be self-limiting. During work, therefore, the impending loss of excitability has to be counterbalanced by prompt restoration of Na+-K+ gradients. Since this is the major function of the Na+-K+ pumps, it is crucial that their activity and capacity are adequate. This is achieved in two ways: 1) by acute activation of the Na+-K+ pumps and 2) by long-term regulation of Na+-K+ pump content or capacity. 1) Depending on frequency of stimulation, excitation may activate up to all of the Na+-K+ pumps available within 10 s, causing up to 22-fold increase in Na+ efflux. Activation of the Na+-K+ pumps by hormones is slower and less pronounced. When muscles are inhibited by high [K+]o or low [Na+]o, acute hormone- or excitation-induced activation of the Na+-K+ pumps can restore excitability and contractile force in 10-20 min. Conversely, inhibition of the Na+-K+ pumps by ouabain leads to progressive loss of contractility and endurance. 2) Na+-K+ pump content is upregulated by training, thyroid hormones, insulin, glucocorticoids, and K+ overload. Downregulation is seen during immobilization, K+ deficiency, hypoxia, heart failure, hypothyroidism, starvation, diabetes, alcoholism, myotonic dystrophy, and McArdle disease. Reduced Na+-K+ pump content leads to loss of contractility and endurance, possibly contributing to the fatigue associated with several of these conditions. Increasing excitation-induced Na+ influx by augmenting the open-time or the content of Na+ channels reduces contractile endurance. Excitability and contractility depend on the ratio between passive Na+-K+ leaks and Na+-K+ pump activity, the passive leaks often playing a dominant role. The Na+-K+ pump is a central target for regulation of Na+-K+ distribution and excitability, essential for second-to-second ongoing maintenance of excitability during work.

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Section: Growth Differentiation and Fiber Typementioning

confidence: 97%

Section: B Catecholaminesmentioning

confidence: 99%

Na⁺-K⁺Pump Regulation and Skeletal Muscle Contractility

Clausen

2003

Physiological Reviews

522

673

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“…Reductions of serum potassium concentrations by 1.5 mEq/L have been obtained as quickly as within an hour [169]. Such therapy has been shown to be safe and effective even in premature infants, with no differences in heart rate, CNS symptoms, ECG anomalies, hyperglycemia, or intraventricular hemorrhage when two nebulizations with albuterol were compared to two saline nebulization treatments [170].…”

Section: Therapies Redistributing Potassiummentioning

confidence: 97%

Physiology of the Developing Kidney: Fluid and Electrolyte Homeostasis and Therapy of Basic Disorders (Na/H2O/K/Acid Base)

Ashoor¹,

Somers²

2015

Pediatric Nephrology

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“…28,56 5) Hiperkalemi: Hiperkalemi tedavisinde nebülize levalbuterol ve albuterol tedavisi K'yi düşürmede etkili bir tedavi yöntemi olarak düşünülmüştür. 62 6) İnhale viral tedavi: Bir nüklotit analoğu olan ribavirinin inhale olarak kullanılması Amerika Birleşik Devletleri'nde Ulusal İlaç Ajansı'ndan (Federal Drug Administration -FDA) onay almıştır. İnhale ribavirin tedavisinin, RSV bronşiyolitli entübe infantlarda ventilatörde kalış süresini kısalttığı, ancak mortalite üzerine etkisi olmadığı gösterilmiş-tir.…”

Section: ) Gen Terapi Vektörleri (Cftr-avv)unclassified