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Urinary potassium excretion in the critically ill neonate
Pediatrics
|August 1, 1984
Summary
Critically ill preterm infants may experience negative potassium balance due to low intake and increased prostaglandin E2. Supplementing potassium is crucial to prevent hypokalemia in these vulnerable newborns.
Area of Science:
- Neonatalogy
- Pediatric Nephrology
- Biochemistry
Background:
- Critically ill preterm neonates are at risk for negative potassium balance.
- Factors contributing include low potassium intake, elevated aldosterone, increased prostaglandin synthesis, and diuretic use.
Purpose of the Study:
- To investigate the relationship between potassium balance and renal prostaglandin excretion in preterm infants with respiratory distress syndrome.
- To assess potassium levels and balance in stressed preterm neonates.
Main Methods:
- Sequential timed-urine collections were performed on nine infants with respiratory distress syndrome during the first four postnatal days.
- These infants were compared to 18 preterm infants without respiratory distress syndrome.
- Plasma potassium concentrations and urinary prostaglandin E2 excretion were measured.
Main Results:
- Plasma potassium concentrations significantly decreased from day 1 to day 4 in infants with respiratory distress syndrome (4.87 to 3.83 mEq/L).
- Cumulative potassium balance was negative (-4.07 mEq/kg), representing 10% of total body potassium.
- Urinary prostaglandin E2 excretion was significantly higher on day 1 in infants with respiratory distress syndrome compared to controls (22.0 vs 8.3 ng/mg creatinine).
Conclusions:
- Preterm infants with respiratory distress syndrome are prone to hypokalemia.
- Elevated renal prostaglandin E2 may contribute to negative potassium balance in these infants.
- Adequate potassium supplementation and cautious use of drugs affecting prostaglandins or potassium excretion are recommended for stressed preterm infants.