• Bindya S Singh, H Farouk Sadiq, Akihiko Noguchi, and William J Keenan.
• Division of Neonatology, Department of Pediatrics, Saint Louis University School of Medicine, Cardinal Glennon Children's Hospital, Missouri, USA.
• J. Pediatr. 2002 Jul 1;141(1):16-20.

ObjectiveTo 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.Study DesignNeonates <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.ResultsNineteen 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).ConclusionAlbuterol inhalation may be useful in rapidly lowering serum potassium levels in premature neonates.

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