EFFECTIVE TREATMENT OF ACUTE HYPERKALEMIA IN CHILDHOOD BY SHORT-TERM INFUSION OF SALBUTAMOL

Hyperkalaemia is a life-threatening emergency and infusion of glucose with insulin has so far been regarded as the standard treatment of cho ice. Recently the beta-2 stimulatory drug salbutamol has been shown to be an effective agent to treat hyperkalaemia by inducing a shift of p otassium into the intracellular compartment. We treated 15 children ag ed 0.1-14 (mean 5.2) years suffering from acute hyperkalaemia (mean le vel 6.6 +/- 0.54, range 5.9-7.7 mmol/l) with a single infusion of salb utamol (5 mu g/kg over 15 min). Serum potassium concentrations decreas ed significantly within 30 min to levels of 5.74 +/- 0.53 and 4.92 +/- 0.53 mmol/l after 120 min (P < 0.001, respectively). No side-effects occurred other than a slight increase in heart rate in 3 patients. Con clusion A single intravenous infusion of salbutamol at a dose of 5 mu g/kg is a highly effective treatment for hyperkalaemia with minimal cl inical side-effects. The effect lasts for at least 120 min and may rev erse hyperkalaemia in some patients without further interventions so t hat salbutamol seems justified as the first choice treatment for this condition in childhood.