Letters

My name is Roberta Clark and I have subscribed to your journal for many years as well as published in it. I was recently reading an article in the March/April 2007 issue entitled "Potassium and Sodium Homeostasis in the Neonate," and have a few questions. On page 127, Table 1 lists the common therapies for hyperkalemia, and the first question I have is what reference(s) did the author use to extrapolate that data? The formula for the insulin glucose infusion is very vague. It states that one should start insulin 0.2 unit/kg/hour with glucose 0.5 gm/kg/hour, and I am uncertain as to what this actually means. First of all, how does one calculate gm/kg/hour on a glucose infusion when the formula doesn't give a specific concentration of glucose, or is this variable? Then I am curious about whether this is a supplemental infusion or included in the total glucose load for the patient. I retrieved articles number 4 & 12, as referenced in the section "Treatment of K+ Imbalance," and found no information dealing with a specific gm/kg/hour rate of glucose infusion to be used with the initiaition of insulin for hyperkalemia.