Premium
High‐dose calcium reduces early‐onset hyperkalemia in extremely preterm neonates
Author(s) -
Enomoto Masahiro,
Minami Hirotaka,
Takano Tsutomu,
Katayama Yoshinori,
Lee Yong Kye
Publication year - 2012
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.2012.03721.x
Subject(s) - hyperkalemia , medicine , calcium , hypoglycemia , potassium , gestation , anesthesia , pregnancy , insulin , chemistry , organic chemistry , biology , genetics
Background Early‐onset hyperkalemia often occurs in extremely preterm infants during a few days after birth. While there are several treatments for hyperkalemia, calcium infusion to reduce plasma potassium concentrations remains controversial. The purpose of this study is to investigate whether a high dosage of calcium reduces early‐onset hyperkalemia. Methods Extremely low‐birthweight neonates born at 22–25 weeks' gestation were enrolled. We analyzed data using multivariate regression analysis and performed a retrospective cohort study with patients divided into two groups according to the dosage of calcium in their initial infusion. Results A total of 103 patients were eligible. Early‐onset hyperkalemia was observed in 27 patients. The dosage of calcium gluconate during 24 h after birth was the only independent factor affecting early‐onset hyperkalemia. The maximum plasma potassium concentration during 72 h after birth was negatively correlated with the dosage of calcium. High‐dose calcium reduced occurrences of hyperkalemia and hypoglycemia caused by insulin infusion given for treatment of hyperkalemia, without increasing the risk of any other complications. Conclusions Infusion of calcium gluconate may reduce early‐onset hyperkalemia in a dose‐dependent manner.