Potassium disorder / pseudohyperkalemia

[Greice Batista]

Dear colleagues, 

In our unit, we have some disagreements on what to consider hyperkalemia in newborn and at what threshold we should do something. 

In my opinion (based on literature review and units protocols available), I consider an elevated potassium when it is above 5,9 – and we usually would see some repercussion when it is above 6.5. 

I have a lot to discuss about it, but I would like to start with this: what do you consider hyperkalemia? 

Best regards,

Greice Batista

[Flavio Martins]

Hi Greice,

I would do something about it when potassium levels are over 6,0.

Also, It's important to rule out causes of pseudohyperkalemia, especially, artefact of collection process or acidosis.

Thanks for bringing this up!

Flávio Martins

[Manuel]

We become alert with a serum K at 5.5, between 5.5 to 6 if there is any symptoms incluke EKG, and up to 6 with or without symptoms definitely

[M C Fadous Khalife]

We have a lot of processing errors so we never consider before 6,0

[Karen]

Definitely is a difficult diagnosis to make as collection techniques, delays in running sample and polycythaemia can affect the result, often considered spurious.  If asymptomatic but persistent, we would run a free flowing venous sample.  If our 'true' level was >6, we would initially we would stop any infusions with K+ added then we would consider insulin infusion, diuretics, Calcium bolus.