[Results of a National Survey in Germany on incidence and therapy of the nonoliguric hyperkalemia of the premature infant].

BACKGROUND

Although nonoliguric hyperkalemia of the premature infant is a common problem, in many hospitals it is not observed. It is characterized by an excessive increase in serum potassium concentration (serum-[K (+)]) at 24 hours after birth. Recently, salbutamol has been recommended to treat hyperkalemia. There are no controlled trials in premature infants. During the first minutes of salbutamol infusions paradoxical increases in serum-[K (+)] may occur. We asked for possible reasons for the variable incidence of the disorder. We wanted to know if salbutamol is currently applied and if initial increases in serum-[K (+)] during salbutamol infusions have been observed.

MATERIALS AND

METHODS

National survey in Germany.

RESULTS

Questionnaires of 132 hospitals caring for premature infants < 30 gestational weeks. The incidence of hyperkalemia was 0 - 40 %. At least 25 % of all hospitals measured serum-[K (+)] not before the second day after birth. 52 hospitals had applied salbutamol. Nine hospitals reported increases in serum-[K (+)] associated with salbutamol therapy. However, it was common practice to measure serum-[K (+)] 1 hour (median, range 0.25 - 12 hours) after the start of the infusion. Two cases of cardiac arrhythmias during salbutamol infusion were reported.

DISCUSSION AND

CONCLUSIONS

The variable incidence of hyperkalemia may result from the fact that many hospitals do not measure serum-[K (+)] on the first day after birth. Common practice made it potentially impossible to determine the frequency of initial increases in serum-[K (+)] during salbutamol infusion. However, these data should be available, before controlled trials on salbutamol treatment in premature infants can be initiated.