Treatment of non-oliguric hyperkalaemia with inhaled salbutamol in premature infants with severe respiratory distress syndrome

Sa？etak Non-oliguric hyperkalaemia (NOHK) in neonates is defned as a plasma potassium level > 6.5 mmol/L in the presence of urine output ≥ 1 mL/kg/h during the frst 72 hours of life. It is characterized by a rapid rise of serum potassium to excessively high values, a high risk of cardiac arrhythmias and no occurrence afer 72 hours of birth. NOHK commonly occurs in premature neonates, especially in those with a gestational age <28 weeks, with only a few reports of this entity in moderate or late preterm neonates. Te efectiveness and safety of diferent treatments for NOHK is uncertain and currently there is no frm treatment recommendation. We describe the case of a moderately premature neonate (32+ 2 weeks gestation), with severe neonatal respiratory distress syndrome, who developed NOHK that was treated with inhaled salbutamol. When salbutamol is used for the treatment of NOHK, an initial paradoxical rise in potassium levels should always be taken into account to avoid cardiac arrhythmias