Glucose-insulin infusion for the early treatment of non-oliguric hyperkalemia in extremely-low-birth-weight infants.

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  • Author(s): Hung KC;Hung KC; Su BH; Lin TW; Peng CT; Tsai CH
  • Source:
    Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi [Acta Paediatr Taiwan] 2001 Sep-Oct; Vol. 42 (5), pp. 282-6.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Country of Publication: China (Republic : 1949- ) NLM ID: 100958202 Publication Model: Print Cited Medium: Print ISSN: 1608-8115 (Print) Linking ISSN: 16088115 NLM ISO Abbreviation: Acta Paediatr Taiwan Subsets: MEDLINE
    • Publication Information:
      Original Publication: Taipei, Taiwan : Taiwan Pediatric Association, 1999-2008.
    • Subject Terms:
      Infant, Very Low Birth Weight*; Glucose Solution, Hypertonic/*administration & dosage ; Hyperkalemia/*drug therapy ; Infant, Premature, Diseases/*drug therapy ; Insulin/*administration & dosage; Case-Control Studies ; Chi-Square Distribution ; Humans ; Hyperkalemia/complications ; Hyperkalemia/congenital ; Hyperkalemia/epidemiology ; Infant, Newborn ; Infant, Premature, Diseases/epidemiology ; Infusions, Intravenous ; Logistic Models ; Potassium/blood ; Potassium/urine ; Prospective Studies ; Survival Rate ; Taiwan/epidemiology ; Treatment Outcome
    • Abstract:
      In order to investigate the status of non-oliguric hyperkalemia and to evaluate glucose-insulin infusion treatment among extremely-low-birth-weight (ELBW) infants, 161 infants weighting less than 1000 gm at birth were enrolled for this study. They were divided into two groups: a hyperkalemic group and a non-hyperkalemic group. Hyperkalemia was defined here as a serum potassium level of greater than 6 mEq/L in a non-hemolyzed arterial blood sample. A glucose-insulin infusion was administered to the patients when hyperkalemia was detected in them during the first few days after birth. The infusion was discontinued when the serum potassium levels had been less than 6 mEq/L and stabilized for 6 hours. The incidence of non-oliguric hyperkalemia among ELBW infants in this study was 58% (93/161). The mean gestational age of neonates was 25.7 +/- 1.8 weeks (hyperkalemic) and 26.6 +/- 1.7 weeks (non-hyperkalemic). The mean rate of increases in serum potassium levels was 0.32 +/- 0.29 mEq/L/hr (hyperkalemic) and 0.13 +/- 0.12 mEq/L/hr (non-hyperkalemic). The incidence of severe intraventricular hemorrhage (IVH) was 19% (18/93) (hyperkalemic) and 4.4% (3/68) (non-hyperkalemic). The incidence of cardiac arrhythmia was 12% (11/93) (hyperkalemic) and 0% (non-hyperkalemic) respectively. Neonates with fewer weeks of gestation at birth and faster increases in serum potassium levels were associated with a more prominent tendency toward hyperkalemia. Hyperkalemia markedly increases the risk of severe IVH and arrhythmia for ELBW infants. A higher glucose infusion rate should be maintained to prevent hypoglycemia following insulin treatment.
    • Accession Number:
      0 (Glucose Solution, Hypertonic)
      0 (Insulin)
      RWP5GA015D (Potassium)
    • Publication Date:
      Date Created: 20011204 Date Completed: 20011220 Latest Revision: 20150901
    • Publication Date:
      20231215
    • Accession Number:
      11729704