Hyperkalaemia, cardiac arrhythmias, and cerebral lesions in high risk neonates.

Shortland, David; Trounce, J Q; Levene, M I

doi:10.1136/adc.62.11.1139

Cited by 59 publications

(40 citation statements)

References 11 publications

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“…In our clinical experience, however, this treatment frequently causes glucose derangement and is often ineffective. Cardiac arrhythmia was reported to occur in 60% of infants with NOHK 6) . Arrhythmia developed in 13% of hyperkalemic episodes during P1.…”

Section: Discussionmentioning

confidence: 99%

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The Impact of Fluid Therapy Strategies on Nonoliguric Hyperkalemia in Extremely Low Birth Weight Infants

et al. 2014

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Purpose: The aim of this study was to characterize the changes in the incidence and clinical characteristics of nonoliguric hyperkalemia (NOHK), together with plasma potassium levels, according to the fluid therapy strategies for extremely low birth weight infants (ELBWIs) during the first few days of life.Methods: This retrospective study enrolled ELBWIs. We analyzed the occurrence of NOHK, plasma potassium levels, other biochemical data, and fluid balances according to historically controlled strategies such as conventional limited-volume supply and low-dose calcium supplementation (P1), increased-volume supply and high-dose calcium supplementation (P2), and early aggressive nutrition (EAN) and high-dose calcium supplementation (P3). Results:The incidence of NOHK and the plasma potassium levels in P2 (127 ELBWIs) were not different from those in P1 (39 ELBWIs). However, arrhythmia and fatality significantly decreased in P2 compared to those in P1. In P3 (68 ELBWIs), the incidence of NOHK after 24 h and the plasma potassium levels after 36 h of life were significantly reduced compared to those in P1 and P2. Neither arrhythmia nor fatality developed in P3. Conclusion: EAN combined with high-dose calcium supplementation could be a potential strategy for the prevention of NOHK along with consequent arrhythmia and fatality in ELBWIs.

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Section: Discussionmentioning

confidence: 99%

“…Hyperkalemia can cause cardiac arrhythmias, changes on cranial ultrasonographic findings such as intracerebral hemorrhage and periventricular leukomalacia, and sudden death 6) . To prevent these serious complications of NOHK, effective therapeutic or preventive modalities for hyperkalemia should be provided.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Fluid Therapy Strategies on Nonoliguric Hyperkalemia in Extremely Low Birth Weight Infants

et al. 2014

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“…The major disadvantage of citrated blood is its less physiological composition [21]. Several complications due to its acidity and concentration of sodium [8], potassium [23], calcium [15,18] and glucose [22] have been documented in the literature. Despite these negative aspects, citrated blood is the blood product most often used for ETs throughout the world.…”

Section: Introductionmentioning

confidence: 98%

Exchange transfusion: Evaluating the use of a mixture of citrated red cells and heparinized plasma

1992

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In 1987 a mixture for exchange transfusion was introduced in the Netherlands. It was composed of citrated red cells, heparinized plasma and third-party platelets if necessary. Selected biochemical and haematological properties of this mixture were compared to fresh heparinized whole blood, which was at that time the blood product of choice for exchange transfusion. The parameters of the mixture were less physiological than fresh heparinized whole blood. In addition, retrospective analysis of the same parameters was performed upon 149 blood samples from newborn infants who had undergone exchange transfusion. The bilirubin decreasing capacity of the mixture was adequate. Most other parameters did not change considerably and remained within the physiological range. This mixture may be an adequate product for exchange transfusion. However, to be certain of its safety and suitability, several other biochemical and haematological aspects must be studied in addition to the immunological and infectious risks.

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“…A elevação do KP, além de levar a arritmias cardíacas, pode causar lesões cerebrais 8 . Em nosso meio, ainda não se dispõe de dados que confirmem os achados da literatura internacional.…”

Section: Introductionunclassified

Hyperkalemia in very low birthweight infants: incidence and associated factors

Nader¹,

Procianoy²

1996

J Pediatr (Rio J)

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ResumoO presente estudo avaliou a incidência de hipercalemia (potássio > 6mEq/l) em RNPs com peso < 1250 gramas e idade gestacional < 32 semanas nas primeiras 72 horas de vida, nascidos no Hospital de Clínicas de Porto Alegre, no período de 1 ano. A incidência de hipercalemia foi de 38,5% (potássio > 6 mEq/l) e de 15,4% com níveis de potássio passíveis de arritmias cardíacas (KP > 6,7 mEq/l).A população foi dividida em 2 grupos: grupo KN com potássio < 6mEq/l (16 casos) e grupo KE com potássio > 6 mEq/l (10 casos). A conduta no controle hidroeletrolítico e na manutenção do ambiente térmico neutro foi a mesma nos 2 grupos. Nenhum dos grupos recebeu potássio nas primeiras 36 horas de vida.O grupo KE apresentou níveis de potássio mais elevados durante todo o estudo. As médias dos pesos de nascimento dos grupos não diferiram significativamente (KN = 963 gr; KE = 987 gr). O grupo KN apresentou idade gestacional (29,3 semanas X 30,8 semanas) e índice de Apgar no primeiro minuto (3,18 X 5,7) significativamente menores (p = 0,004 e p = 0,015 respectivamente). Não houve diferença significativa entre os dois grupos em relação a hemorragia intraventricular, acidose, doença da membrana hialina, níveis de insulina, glicemia, índice glicemia/ insulina, taxa de filtração glomerular, diurese, potássio urinário, excreção fracionada de sódio, excreção fracionada de potássio e índice tubular de aldosterona. O nível de aldosterona foi significativamente maior no grupo KE com 24 horas de vida (212,8 ng/dl X 110,2 ng/dl, p=0,029). Sugere-se que nenhum dos fatores estudados é responsável pela hipercalemia não oligúrica do recém-nascido de muito baixo peso, salientando-se, entretanto, a importância de controlar os níveis de potássio sérico nesses recém-nascidos.J. pediatr. (Rio J.). 1996; 72(3):143-150: hipercalemia, recém-nascido prematuro, aldosterona, função renal. AbstractThe present study evaluated the incidence of hyperkalemia in premature babies born at the Hospital de Clínicas de Porto Alegre (birthweight < 1250 grams and gestational age < 32 weeks) during the first 72 hours of life in a one year period. The incidence of hyperkalemia was of 38.5% (potassium levels >6 mEq/l) and 15.4% with potassium levels subject to cardiac arrhythmia (> 6.7 mEq/l).The population was divided into two groups: group KN with potassium < 6 mEq/l (n=16) and group KE with potassium > 6 mEq/l (n=10). The hydroelectrolyte management and maintenance of neutral thermal environment was the same for both groups. Neither group received potassium in the first 36 hours of life.The KE group presented higher potassium levels during all the study. The mean birthweights of the groups were similar (KN = 963 gr; KE = 987 gr). The KN group presented a mean gestational age (29.3 weeks x 30.8 weeks) and Apgar Score in the first minute of life (3.18 x 5.7) significantly lower (p = 0.004 and p = 0,015 respectively) than the KE group. There were no significant differences between both groups in relation to the intraventricular hemorrhage, acidosis, hialine membrane disea...

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Hyperkalaemia, cardiac arrhythmias, and cerebral lesions in high risk neonates.

Cited by 59 publications

References 11 publications

The Impact of Fluid Therapy Strategies on Nonoliguric Hyperkalemia in Extremely Low Birth Weight Infants

The Impact of Fluid Therapy Strategies on Nonoliguric Hyperkalemia in Extremely Low Birth Weight Infants

Exchange transfusion: Evaluating the use of a mixture of citrated red cells and heparinized plasma

Hyperkalemia in very low birthweight infants: incidence and associated factors

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