All issues > Volume 42(10); 1999

Original Article

J Korean Pediatr Soc. 1999;42(10):1366-1372. Published online October 15, 1999.

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

Young Pyo YP Chang¹

¹Department of Pediatrics, College of Medicine, Dankook University, Cheonan, Korea

Correspondence Young Pyo YP Chang ,Email: 1

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(≥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 of 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(≥6.5mEq/L) had electrocardiographic abnormalities and eight infants had hyperkalemia-induced cardiac arrhythmia 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 group (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.

Keywords :Hyperkalemia, Prematurity