Early Onset Hyperkalemia within 72 Hours after Birth in Extremely Preterm Infants

Chang, Young Pyo

Abstract

PURPOSE: The incidence of hyperkalemia and the factors contributing the serum potassium level within 72 hours after birth in extremely preterm infants were determined.
METHODS
The incidence of hyperkalemia and differences of clinical features between hyperkalemic(> OR =6.5mEq/L) and normokalemic(<6.5mEq/L) groups were determined by reviewing medical records of 53 extremely preterm infants born at less than 28 weeks gestation.
RESULTS
The mean birth weight and gestational age were 912+/-186gram and 26.2+/-1.3weeks respectively. Thirty-six infants(67.9%) had at least one serum potassium level that exceeded 6.5mEq/L, and 15 infants with hyperkalemia(> OR =6.5mEq/L) had electrocardiographic abnormalities and eight infants had hyperkalemia-induced cardiac arrhythmias such as ven-tricular tachycardia, fibrillation and/or bradycardia. Serum potassium peaked in 13-36 hour postnatal age and the incidence of electrocadiographic abnormalities was highest in the 13-36 hour postnatal age(P<0.05). Urine flow rate during the first 48 hours after birth was only significantly lower for hyperkalemic infants(P<0.05). Six infants with hyperkalemia died as a direct result of hyperkalemia-induced cardiac arrhythmia.
CONCLUSION
Hyperkalemia frequently occurred within the first 72 hours of life in extremely premature infants. Serum potassium should be monitored closely to avoid life-threatening cardiac arrhythmia in these infants.