Efficacy of albuterol inhalation in treatment of hyperkalemia in premature neonates.
OBJECTIVE
To evaluate the efficacy of inhaled albuterol for treatment of hyperkalemia in premature neonates by conducting a prospective, randomized placebo-controlled and double-blinded clinical trial.


METHODS
Neonates <2000 g receiving mechanical ventilation with central serum potassium > or =6.0 mmol/L (6.0 mEq/L), were randomly assigned to treatment or placebo groups. Albuterol (400 microg) or saline was given by nebulization. The dose was repeated every 2 hours until the potassium level fell below 5 mmol/L (maximum 12 doses) or there were signs of toxicity.


RESULTS
Nineteen patients completed the study (8 in the albuterol and 11 in the saline group). Serum potassium levels declined rapidly in the first 4 hours in the albuterol group, from 7.06 +/- 0.23 mmol/L to 6.34 +/- 0.24 mmol/L (P =.003) versus no significant change in the saline group (6.88 +/- 0.18 mmol/L to 6.85 +/- 0.24 mmol/L; P =.87). At 8 hours, the fall continued to be greater in the albuterol group versus the saline group (5.93 +/- 0.3 mmol/L and 6.35 +/- 0.22 mmol/L, respectively; P =.04).


CONCLUSIONS
Albuterol inhalation may be useful in rapidly lowering serum potassium levels in premature neonates.
Singh
Bindya S
BS
Division of Neonatology, Department of Pediatrics, Saint Louis University School of Medicine, Cardinal Glennon Children's Hospital, Missouri, USA.
Sadiq
H Farouk
HF
Noguchi
Akihiko
A
Keenan
William J
WJ
D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000420:Albuterol / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000188:drug therapy*; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011446:Prospective Studies
D000318:Adrenergic beta-Agonists; D000420:Albuterol