A 720 g neonate in the intensive care unit develops severe hyperkalaemia with cardiac arrhythmia. The specialist registrar decides to give a calcium gluconate bolus and start an insulin and dextrose infusion. The new registrar queries why salbutamol and ion exchange resins were not considered as these therapies are frequently used in the management of hyperkalaemia in older children and adults.

Structured clinical question

In non-oliguric hyperkalaemic very low birth weight (VLBW) neonates [patient] which medical interventions [therapy] reduce serum potassium levels effectively [outcome]?

Search strategy and outcome

Search date: August 2006.

Secondary search

Cochrane Library (2006, Issue 4). One relevant systematic review.

Primary search

Pubmed and Medline 1966–2006; Embase 1974–2006; Cinahl 1982–2006 using Dialog Datastar.

Search terms: [neonatal hyperkalaemia or hyperkalaemia AND neonate or hyperkalaemia AND preterm neonate or hyperkalaemia and newborn] AND [treatment or therapy or drug therapy or insulin/dextrose infusion or insulin/glucose infusion or salbutamol or calcium or calcium gluconate or calcium resonium or ion exchange resin or sodium bicarbonate or exchange transfusion or …