Acid base and electrolyte disturbance in diarrhoea.

OBJECTIVE: The present study was undertaken to study the frequency of electrolyte imbalance in children with diarrhoea and the relationship between electrolyte abnormalities and mortality. MATERIALS AND METHODS: This is a retrospective, observational hospital based study. Fifty seven children admitted to paediatric ward with diarrhoea and dehydration was evaluated for electrolyte and acid base status at presentation. The variables were analyzed using chi-square and student t- test. RESULTS: Majority (70%) of patients were below 2 years of age. There were 37 (65%) males and 20(35%) females. Electrolyte disturbance was observed in 46 (80%) patients while acid base disturbance was observed in all (100%) where the estimations were done. The major electrolyte disturbances noted were hyponatremia (56%), which was either isolated (26%) or associated with hypokalemia (26%). The second common abnormality was hypokalemia (46%) which was again either isolated (14%) or associated with hyponatremia (26%). About 10% patient had hypernatremia and about 3% had hyperkalemia. Twenty one (37 %) patients had mixed electrolyte imbalance. ABG analysis was performed only in 16 patients. Arterial blood gas analysis could be performed only in 16 patients. Metabolic acidosis was present in 15 (94%) while one (6%) had metabolic alkalosis. Out of 57, five patients (8.7%) expired. All of them had electrolyte abnormalities. Out of five patients who died one had isolated hyponatremia, 2 had hyponatremia + hypokalemia, while one each had hypernatremia + hypokalemia and hypernatremia+ hyperkalemia. Statistically significant mortality was observed in patients presenting with either hyponatremia or hypokalemia as compared to the group with normal electrolytes. CONCLUSION: Hyponatremia, hypokalemia and metabolic acidosis are common electrolyte and acid-base abnormalities in children with diarrhoea and dehydration and often responsible for mortality.

Desequilibrio ácido base en la unidad de cuidados intensivos / Acid basic disbalance in the intensive care unit

Este estudio se diseñó para determinar la frecuencia de las alteraciones ácido-base en una muestra de pacientes ingresados a una unidad de cuidados intensivos generales, mediante un estudio descriptivo y transversal. Se incluyeron 30 pacientes que ingresaron a la unidad de cuidados intensivos en quienes se revisó la determinación de gases arteriales y electrólitos séricos, así como la brecha aniónica. Mediante nomograma se identificaron los trastornos ácido-base mixtos. Los resultados mostraron, en todos los pacientes, desequilibrio ácido-base. El mayor porcentaje de casos fue en pacientes con alcalosis respiratoria crónica (46.6 por ciento), que invariablemente sucedió en quienes presentaban cardiopatía isquémica. La mortalidad fue mayor en pacientes con trastornos ácido-base mixtos