Hypernatraemia induced by sodium polystyrene sulphonate (Kayexalate) in two extremely low birth weight newborns.
Hyperkalaemia is a life-threatening electrolyte disorder that can occur in the first week of life in almost 50% of preterm infants with a birth weight less than 1000 g [extremely low birth weight (ELBW)]. Serum potassium values higher than 7 mmol x l-1 are associated with cardiac arrhythmias and an increased incidence of intraventricular haemorrhage and periventricular leucomalacia. Therapeutic options to treat this dangerous imbalance comprise calcium gluconate, insulin plus glucose, albuterol/salbutamol inhalation. Administration of cation-exchange resin such as sodium polystyrene sulphonate (Kayexalate) is effective in lowering plasma potassium, although complications following oral or rectal administration are reported in newborns. We describe two ELBW infants affected by hyperkalaemia, treated with Kayexalate, who developed serious hypernatraemia, that has never been reported before in preterm infants.
Neonatal Intensive Care Unit, Department of Critical Care Medicine, University Careggi Hospital, Florence, Italy. filippi.luca@virgilio.it
Luca
L
Filippi
Alessandra
A
Cecchi
Carlo
C
Dani
Giovanna
G
Bertini
Marco
M
Pezzati
Firmino F
FF
Rubaltelli
D002411:Cation Exchange Resins / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000188:drug therapy*; D006955:Hypernatremia / Q000139:chemically induced*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D019102:Infant, Very Low Birth Weight; D011137:Polystyrenes / Q000009:adverse effects*
D002411:Cation Exchange Resins; D011137:Polystyrenes; C003321:polystyrene sulfonic acid