Nebulized salbutamol diminish the blood glucose fluctuation in the treatment of non-oliguric hyperkalemia of premature infants

• Published in: Journal of the Chinese Medical Association Vol. 82; no. 1; pp. 55 - 59
• Main Authors: Saw, Hean-Pat, Chiu, Cheng-Di, Chiu, You-Pen, Ji, Hui-Ru, Chen, Jia-Yuh
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Taiwan LLC 01.01.2019
• Subjects: Albuterol - administration & dosage; Blood Glucose - analysis; Blood Pressure - drug effects; Blood sugar; Double-Blind Method; Heart Rate - drug effects; Humans; Hyperkalemia; Hyperkalemia - blood; Hyperkalemia - drug therapy; Hyperkalemia - physiopathology; Infant, Newborn; Infant, Premature; Nebulizers and Vaporizers; Nebulizers usage; Premature infant; Prospective Studies; Salbutamol; Hyperkalemia; Nebulizers usage; Salbutamol; Premature infant; Blood sugar
• ISSN: 1726-4901; 1728-7731
• DOI: 10.1016/j.jcma.2018.04.002

Hyperkalemia is a risky and potentially life-threatening condition in pre-term infants. Glucose-insulin infusion has been considered a major therapeutic way for non-oligouric hyperkalemia but affects the stability of blood sugar level. We aimed to evaluate the effectiveness of salbutamol nebulization compared to glucose-insulin infusion for the treatment of non-oliguric hyperkalemia in premature infants. Forty premature infants (gestation age ≤36 weeks) with non-oliguric hyperkalemia (central serum potassium level greater than 6.0 mmol/L) within 72 h of birth were enrolled in this study. These infants were randomly assigned into two groups. One group received a regular insulin bolus with glucose infusion (Group A; n = 20), and the other received salbutamol (Ventolin®) by nebulization (Group B; n = 20). Potassium level, blood sugar, heart rate, and blood pressure were recorded for each group before treatment and at 3, 12, 24, 48, and 72 h post-treatment. The serum potassium levels were reduced after treatment in both groups. No significant changes in heart rate or blood pressure were observed in either group. The fluctuation in glucose levels was gentler in the salbutamol-treated group than in the glucose-insulin infusion group. Salbutamol nebulization is not only as effective as glucose-insulin infusion for treating non-oliguric hyperkalemia in premature infants but can avoid potential side effects such as vigorous blood glucose fluctuations.