Reviewed by Clinical Practice Committee
Clinical Guidelines Back Newborn Services Home Page
Definition and Diagnosis Aetiology Complications Treatment References

If you consider treatment for hyperkalaemia, discuss with the specialist on call.

Definition and Diagnosis




  1. 10% Calcium Gluconate

  1. Stop IV K+

  1. IV Dextrose and Insulin

  1. Salbutamol

  1. Sodium bicarbonate

Correction of an existing metabolic acidosis can be considered

  1. Resonium

Should be avoided in preterm infants

  1. Exchange transfusion or peritoneal dialysis


1 Gruskay J, Costarino AT, Polin RA, Baumgart S. Nonoliguric hyperkalemia in the premature infant weighing less than 1000 grams. J Pediatr. 1988;113:3816.
2 Lista G, Bastrenta P, Castoldi F, Meneghin F, Zuccotti G. Severe bradycardia in an extremely low birth weight preterm infant with hyperkalaemia. Resuscitation [Internet]. European Resuscitation Council, American Heart Association, Inc., and International Liaison Committee on Resuscitation.; 2011;82:6401.
3  Vemgal P, Ohlsson A. Interventions for non-oliguric hyperkalaemia in preterm neonates. Cochrane database Syst Rev. 2012;5:CD005257.
4 Hu PS, Su BH, Peng CT, Tsai CH. Glucose and insulin infusion versus kayexalate for the early treatment of non-oliguric hyperkalemia in very-low-birth-weight infants. Acta Paediatr Taiwan;40:3148.
5 Singh BS, Sadiq HF, Noguchi A, Keenan WJ. Efficacy of albuterol inhalation in treatment of hyperkalemia in premature neonates. J Pediatr. 2002 ;141:1620.
6 Yaseen H, Khalaf M, Dana A, Yaseen N, Darwich M. Salbutamol versus cation-exchange resin (kayexalate) for the treatment of nonoliguric hyperkalemia in preterm infants. Am J Perinatol. 2008;25:1937.
7 Setzer ES, Ahmed F, Goldberg RN, Hellman RL, Moscoso P, Ferrer PL, et al. Exchange transfusion using washed red blood cells reconstituted with fresh-frozen plasma for treatment of severe hyperkalemia in the neonate. J Pediatr. 1984;104:4436.