Awlad Thani Saif, Al Farsi Muzna, Al Omrani Sara
Royal Hospital, Muscat, Oman.
Int J Pediatr Adolesc Med. 2019 Sep;6(3):118-120. doi: 10.1016/j.ijpam.2019.04.001. Epub 2019 Apr 17.
Hyperkalemia is a life threatening electrolyte imbalance that may be fatal if not treated appropriately. There are multiple medications used to treat hyperkalemia to lower it to a safe level. We report a case of a 4-month old infant with Pseudohypoaldosteronism who had cardiac arrest secondary to severe hyperkalemia of 12.3mmol/l. It was refractory to anti hyperkalemic medications that necessitated the transfer of the patient to a tertiary hospital for dialysis. The potassium level has dropped gradually to a normal level with continuous insulin infusion and dextrose for almost 12 hours that waved the need of the dialysis. This case highlights the effectiveness of prolonged continuous insulin infusion in treating life-threatening hyperkalemia especially in hospitals where there are no dialysis services available or until the dialysis is initiated.
高钾血症是一种危及生命的电解质失衡，如果治疗不当可能会致命。有多种药物用于治疗高钾血症，以将其降至安全水平。我们报告了一例4个月大的患有假性醛固酮减少症的婴儿，因严重高钾血症（血钾水平达12.3mmol/l）继发心脏骤停。抗高钾血症药物对此无效，因此需要将患者转至三级医院进行透析。通过持续输注胰岛素和葡萄糖近12小时，血钾水平逐渐降至正常，从而避免了透析的需要。该病例凸显了长时间持续输注胰岛素在治疗危及生命的高钾血症方面的有效性，尤其是在没有透析服务或尚未开始透析的医院。
