Original scientific paper
ELECTROLYTE AND ACID-BASE DISTURBANCES IN CRITICALLY ILL NEONATES
DEVLETA HADŽIĆ
; Tuzla University Clinical Center, Clinical Department of Pediatrics, Tuzla, Bosnia and Herzegov
NADA MLADINA
; Tuzla University Clinical Center, Clinical Department of Pediatrics, Tuzla, Bosnia and Herzegov
DŽENANA SOFTIĆ
; Tuzla University Clinical Center, Clinical Department of Pediatrics, Tuzla, Bosnia and Herzegov
DELILA SOFTIĆ
; Tuzla University Clinical Center, Clinical Department of Pediatrics, Tuzla, Bosnia and Herzegov
Abstract
The prevalence of electrolyte and acid-base disturbances in neonates are not suffi ciently known. In addition, normal electrolyte and acid-base status parameters in healthy and ill-affected neonates according to gestational and postnatal age have not yet been properly defi ned. The aim of the study was to determine the prevalence of electrolyte and acidbase disorders in critically ill neonates. We analyzed prospectively collected history, clinical and laboratory data, including electrolyte and acid-base parameters, on 100 consecutive neonates admitted to Department of Intensive Care, Clinical Department of Pediatrics, Tuzla University Clinical Center, from January 2017 to May 2017. On statistical analysis, standard methods of descriptive statistics were employed. The most common disorder was metabolic acidosis (80%), followed by respiratory acidosis, found in 55 (55%) patients, while alkalosis was less common: 18 and 4 critically ill newborns with
respiratory and metabolic acidosis, respectively. Mixed acid-base disorders were recorded in 63 (63%) patients. Elevated anion gap was found in 16 (16%) and elevated corrected anion gap in 30 (30%) patients. The grade of metabolic and respiratory acidosis correlated with the disease severity. Statistically signifi cant differences according to gestational age were found for pH, base excess, sodium, chloride, calcium, urea and albumin. In addition to hypoalbuminemia, hyponatremia, hypochloremia and hypocalcemia were mostly reported. Fluid, electrolyte and acid-base balance are essential components
in the treatment of neonates at a high risk. It is particularly important in low birth weight neonates. Premature infants usually require parenteral nutrition and fl uid, the quantity and composition of which may greatly vary. They also have important developmental restrictions in renal homeostatic mechanisms. Finally, prematurity makes them particularly vulnerable and susceptible to morbidity and mortality, which can be signifi cantly associated with fl uid, electrolyte and acid-basemimbalance. In conclusion, over-representation of metabolic disorders in our study may in part be explained by the specific physiology of this population, with the disease process itself or therapy related complications as additional risk factors. Careful clinical monitoring and rapid correction can help improve the outcomes.
Keywords
neonate; electrolyte and acid-base disturbances; risk factors
Hrčak ID:
193691
URI
Publication date:
13.2.2018.
Visits: 5.731 *