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Neonatal Intensive Care Drug Manual
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| bet | 496/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Evidence
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Efficacy
There are no reported trials on the efficacy and safety of potassium therapy in hypokalaemia in neonates. Parenteral potassium: Dose of 0.3 to 0.5 mmol/kg/dose (up to a maximum of 1 mmol/kg/dose) has been suggested to treat severe hypokalaemia.(2)
Enteral potassium: Limited evidence in infants and children suggests enteral potassium replacement may be an equally efficacious alternative first-line therapy in treating hypokalaemia. (8) (LOE II GOR C) Merchant et. al. (8) performed an open-label randomised trial to study the serum potassium changes with enteral versus IV potassium in hypokalaemic infants and children (aged 1 month to 15 years), undergoing surgical repair/palliation of a congenital heart lesion. In the IV arm, dilutions were 80 mmol/L for a peripheral line and 150 mmol/L for a central line. In the oral potassium chloride group, the concentration used was 13.33 mmol/5 mL. The parenteral/enteral dose used was 0.1-0.3 mmol/kg dose for serum potassium 3.5-4.4 mmol/L; 0.5 mmol/kg/dose for serum potassium 3.0-3.4 mmol/L and 0.7-1.0 mmol/kg/dose for serum potassium <3.0 mmol/L. There was no statistically significant difference in change in potassium levels after either enteral or parenteral route.
Safety
In Merchant’s trial of enteral and intravenous potassium, no mortality was reported in either arm. A few episodes of vomiting were reported in enteral route presumably because of poor taste or rapid administration.(8)
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