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

Journal of the Korean Pediatric Society 1999;42(10):1366-1372.
Published online October 15, 1999.
Early Onset Hyperkalemia within 72 Hours after Birth in Extremely Preterm Infants
Young Pyo Chang
Department of Pediatrics, College of Medicine, Dankook University, Cheonan, Korea
초극소 미숙아에서 생후 72시간 내에 발생하는 조기 발현 고칼륨혈증에 관한 연구
장영표
단국대학교 의과대학 소아과학교실
Correspondence: 
Young Pyo 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.
Key Words: Hyperkalemia, Prematurity


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