neonatal hyperkalemia l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Neonatal Hyperkalemia PowerPoint Presentation
Download Presentation
Neonatal Hyperkalemia

Loading in 2 Seconds...

play fullscreen
1 / 7

Neonatal Hyperkalemia - PowerPoint PPT Presentation


  • 733 Views
  • Uploaded on

Neonatal Hyperkalemia. Mother: 30 years old. 2nd pregnancy US at 28 wks : “normal” kidneys Delivery at 33 weeks. Female. Birth Wt 1650 g Apgar 4-7 RDS. Neonatal Hyperkalemia. Day 4: Cardiac ar rhythmia ; BP 65/45 mmHg Na/K 134/ 7.7 mEq/L pH 7.22 and tCO2 12 mmol/L

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Neonatal Hyperkalemia' - callista


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
neonatal hyperkalemia
Neonatal Hyperkalemia

Mother: 30 years old. 2nd pregnancy

US at 28 wks : “normal” kidneys

Delivery at 33 weeks. Female.

Birth Wt 1650 g Apgar 4-7

RDS

slide2

Neonatal Hyperkalemia

Day 4: Cardiac arrhythmia; BP 65/45 mmHg

Na/K 134/7.7 mEq/L pH 7.22 and tCO2 12 mmol/L

URINE RBC “1+”, protein “1+”, Na 45 mmol/L

US no dilatation of urinary tract

slide3

Neonatal Hyperkalemia

Serum creatinine concentration 2.3 mg/dl

Urine volume 1.2 ml/kg/hour

Definition of hyperkalemia

Glucose and insulin infusion ???

Kayexalate ???

slide4

Neonatal Hyperkalemia - Definition

  • K > 6.5 or 7 mEq/L
  • In older children > 5,5 mEq/L
  • Major problem of hyperkalemia:
  • Cardiac arrythmias 25-35 %
  • Death (? %).
slide5

Neonatal Hyperkalemia -Management

Glucose and insulin infusion

Glucose/insulin ratio: 2.0-2.5 g/IU,

Delivered dextrose: 0.45 g/kg/h

In addition to the pre-existing stable

maintenance glucose intake

Lui K et al Acta Paediatr 1992 81(3):213-6

Kayexalate 1 gm/Kg rectally every four hours

Lui K et al Acta Paediatr 1992 81(3):213-6

slide6

Neonatal Hyperkalemia -Management

Glucose and insulin infusion versus Kayexalate

Duration of hyperkalemia (hours)

26.4 +/- 14.9 (GI) and 38.6 +/- 13.3 (Kayexalate)

Grade II and above intraventricular hemorrhage

15% (3/20) and 50% (10/20)

Cardiac dysrhythmias

5% (1/20) and 10% (2/20)

Hu PS et al 1999

slide7

Neonatal Hyperkalemia - Differential diagnosis

  • Acute and chronic renal failure
  • Adrenal insufficiency
  • Hyporeninemic hypoaldosteronism
  • Transcellular redistribution of K.
  • Acute tissue breakdown
  • Transfusion of red cells with high K levels.
  • Gordon syndrome
  • (hypertension with hyperkalemic acidosis)