[Hyperkalemia--life-threatening early complication of asphyxia in premature infants].

16 premature infants with hyaline membrane disease all under mechanical ventilation developed severe electrolyte disturbances during the first 48 hours. The serum potassium concentration increased over 8 mmol/l. After a delay of several hours the serum calcium concentration decreased to 1.0-1.4 mmol/l. The metabolic-respiratory acidosis (pH 6.92-7.19) was present in nearly all patients. The typical hyperkalemic cardiac arrhythmia appeared in 7 patients; six of them died. The quick shifting of potassium from the extracellular into the intracellular space by the glucose-insulin infusion was indispensable for the survival of our patients. The serum potassium concentration decreased by 2.9-5.1 mmol/l in 4 hours. When the cardiac arrhythmia is present calcium gluconate and bicarbonate must be infused immediately followed by the glucose-insulin infusion.