Risk of tachycardia, hypertension and hyperglycaemia Print or save rhythm for evidenceĬaution in patients on digoxin- run infusion over 30 mins Repeat dose if ECG changes persist after 10 mins *Refer to WOS or regional neonatal monograph for detailed guidance on dosage and administration (links to WOS monographs below)* This guideline covers aetiology, diagnosis and acute management of hyperkalaemia on the neonatal unit. This process may be complicated or delayed in certain pathologies which are important to consider if hyperkalaemia is detected. The onset of diuresis and increase in glomerular filtration rate facilitates potassium excretion and serum potassium levels usually normalise by 72-96 hours of age. Proposed mechanisms for this include potassium release from catabolised cells, transcellular shift of potassium into the extracellular compartment and immaturity of renal tubular mechanisms responsible for potassium excretion. Serum potassium levels in this population usually peak at around 24 hours of age. ![]() It is most commonly seen in extreme preterm infants (<28 weeks) and/or very low birth weight (VLBW) infants (<1500g) including those without renal impairment (non-oliguric hyperkalaemia). ![]() ![]() Hyperkalaemia is a potentially life-threatening condition, which if untreated can lead to fatal arrhythmias and death. Hyperkalaemia is usually defined as a serum potassium level of >6.5 mmol/L. The normal range of serum potassium levels in the newborn is 3.5 – 6.0mmol/L.
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