[Hyperkalemia--life-threatening early complication of asphyxia in premature infants].
16 premature infants with hyaline membrane disease all under mechanical ventilation developed severe electrolyte disturbances during the first 48 hours. The serum potassium concentration increased over 8 mmol/l. After a delay of several hours the serum calcium concentration decreased to 1.0-1.4 mmol/l. The metabolic-respiratory acidosis (pH 6.92-7.19) was present in nearly all patients. The typical hyperkalemic cardiac arrhythmia appeared in 7 patients; six of them died. The quick shifting of potassium from the extracellular into the intracellular space by the glucose-insulin infusion was indispensable for the survival of our patients. The serum potassium concentration decreased by 2.9-5.1 mmol/l in 4 hours. When the cardiac arrhythmia is present calcium gluconate and bicarbonate must be infused immediately followed by the glucose-insulin infusion.
Sychlowy
A
A
Städtische Kinderklinik Gelsenkirchen.
van der Gaag
H
H
Hannen-Hofheinz
I
I
D000136:Acid-Base Equilibrium / Q000502:physiology; D001145:Arrhythmias, Cardiac / Q000628:therapy; D001238:Asphyxia Neonatorum / Q000628:therapy*; D001639:Bicarbonates / Q000008:administration & dosage; D002118:Calcium / Q000097:blood; D002411:Cation Exchange Resins / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D005950:Glucose Solution, Hypertonic; D006801:Humans; D006819:Hyaline Membrane Disease / Q000628:therapy*; D006947:Hyperkalemia / Q000628:therapy*; D007231:Infant, Newborn; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D011137:Polystyrenes / Q000008:administration & dosage; D011188:Potassium / Q000097:blood; D012121:Respiration, Artificial
D001639:Bicarbonates; D002411:Cation Exchange Resins; D005950:Glucose Solution, Hypertonic; D007328:Insulin; D011137:Polystyrenes; C003321:polystyrene sulfonic acid; D011188:Potassium; D002118:Calcium
Hyperkaliämie--lebensbedrohliche Frühkomplikation asphyktischer Frühgeborener.