Singh Bindya S, Sadiq H Farouk, Noguchi Akihiko, Keenan William J
Division of Neonatology, Department of Pediatrics, Saint Louis University School of Medicine, Cardinal Glennon Children's Hospital, Missouri, USA.
J Pediatr. 2002 Jul;141(1):16-20. doi: 10.1067/mpd.2002.125229.
To evaluate the efficacy of inhaled albuterol for treatment of hyperkalemia in premature neonates by conducting a prospective, randomized placebo-controlled and double-blinded clinical trial.
Neonates <2000 g receiving mechanical ventilation with central serum potassium > or =6.0 mmol/L (6.0 mEq/L), were randomly assigned to treatment or placebo groups. Albuterol (400 microg) or saline was given by nebulization. The dose was repeated every 2 hours until the potassium level fell below 5 mmol/L (maximum 12 doses) or there were signs of toxicity.
Nineteen patients completed the study (8 in the albuterol and 11 in the saline group). Serum potassium levels declined rapidly in the first 4 hours in the albuterol group, from 7.06 +/- 0.23 mmol/L to 6.34 +/- 0.24 mmol/L (P =.003) versus no significant change in the saline group (6.88 +/- 0.18 mmol/L to 6.85 +/- 0.24 mmol/L; P =.87). At 8 hours, the fall continued to be greater in the albuterol group versus the saline group (5.93 +/- 0.3 mmol/L and 6.35 +/- 0.22 mmol/L, respectively; P =.04).
Albuterol inhalation may be useful in rapidly lowering serum potassium levels in premature neonates.
通过进行一项前瞻性、随机、安慰剂对照双盲临床试验，评估吸入沙丁胺醇治疗早产儿高钾血症的疗效。
体重<2000g且接受机械通气、中心血清钾≥6.0mmol/L（6.0mEq/L）的新生儿被随机分为治疗组或安慰剂组。通过雾化给予沙丁胺醇（400μg）或生理盐水。每2小时重复给药一次，直至血钾水平降至5mmol/L以下（最多12剂）或出现中毒迹象。
19名患者完成了研究（沙丁胺醇组8名，生理盐水组11名）。沙丁胺醇组血清钾水平在最初4小时迅速下降，从7.06±0.23mmol/L降至6.34±0.24mmol/L（P = 0.003），而生理盐水组无显著变化（6.88±0.18mmol/L至6.85±0.24mmol/L；P = 0.87）。在8小时时，沙丁胺醇组的下降幅度继续大于生理盐水组（分别为5.93±0.3mmol/L和6.35±0.22mmol/L；P = 0.04）。
吸入沙丁胺醇可能有助于快速降低早产儿的血清钾水平。
