Serum Electrolytes Abnormalities and Prediction of Outcome in Critically Sick Children

Aims: To study the role of serum electrolyte abnormalities in predicting outcome in critically ill children.

Material & Methods: It was a prospective study comprising of critically ill children admitted in a

PICU of a tertiary care hospital in the northern Indian state of Punjab. At the time of admission

the patient’s clinical picture was recorded in prefixed proforma. Venous blood sampling was

obtained from each patient enrolled in the study and sent for estimation of electrolytes, calcium,

magnesium, phosphorus,urea, creatinine, glucose levels.

Results: There were total 489 admissions to PICU during the study period of one year from 1 May 2015 to 30 April 2016.Out of these 237 cases met the inclusion criteria. Electrolyte abnormalities were observed in 48.5% of children. Male to female ratio was 2.4:1.Maximum patients (29.5%) were less than 1 years age. In our study majority of patients (75.9%) were discharged, with 12.6% discharged against medical advice and 11.4% died. In our study, most common electrolyte abnormality found was hypocalcemia (39.2%) followed by hypokalemia (38.4%) and hyponatremia (37.1%).

Conclusion: The present study showed a high incidence of electrolyte abnormalities in acutely ill children admitted to PICU. Since the specific symptoms of electrolyte abnormality often merge with the underlying disease, they remain unrecognized and contribute significantly to the morbidity and mortality besides the primary illness. Close monitoring and appropriate correction of electrolyte abnormalities will be useful in lowering mortality.