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Homeostasis is the maintenance of a stable internal environment within the body, which is crucial for the proper functioning of cells, tissues, organs, and organ systems. The body has various control mechanisms that work together to regulate various physiological parameters such as temperature, blood pressure, pH balance, and fluid balance, to name a few. These control mechanisms are based on feedback loops that can be either positive or negative.
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In humans, electrolytes play a vital role in various physiological processes. Balancing electrolyte levels is essential for normal body functions; their imbalance can be life-threatening. The major electrolytes include sodium, potassium, chloride, calcium, phosphate, and bicarbonate. They are primarily involved in physiological processes, such as nerve signal transmission, membrane trafficking, muscle contraction, buffering body fluids, and balancing water levels in the body.
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Electrolyte imbalance in critically ill paediatric patients.

Faizia Naseem1, Ayesha Saleem2, Imtiaz Ahmed Mahar3

  • 1Faizia Naseem, MBBS, FCPS. Assistant Professor, Paediatric Unit I, DUHS, Karachi, Pakistan.

Pakistan Journal of Medical Sciences
|August 3, 2019
PubMed
Summary

Electrolyte imbalance is common in critically ill children, affecting 84% of those in the Paediatric Intensive Care Unit (PICU). This condition, particularly hypocalcemia, is linked to increased mortality and longer hospital stays.

Keywords:
Critically ill childrenElectrolyte imbalancesMorbidityMortality

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Area of Science:

  • Pediatric Critical Care Medicine
  • Clinical Biochemistry
  • Pediatric Nephrology

Background:

  • Electrolyte imbalances are frequent complications in critically ill children.
  • Identifying these imbalances is crucial for predicting patient outcomes.
  • The Paediatric Intensive Care Unit (PICU) is a critical setting for managing such cases.

Purpose of the Study:

  • To investigate the incidence and outcomes of electrolyte disturbances in critically ill children.
  • To assess the prognostic significance of electrolyte imbalance in this patient population.
  • To provide data from a public sector hospital in Karachi.

Main Methods:

  • A cohort of 101 children aged one month to 12 years admitted to the PICU was studied.
  • Baseline and serial electrolyte levels (sodium, potassium, calcium, magnesium, phosphorus) were monitored.
  • Data collection occurred over a six-month period (May-October 2017).

Main Results:

  • Electrolyte imbalance was observed in 84% of the children.
  • Hypocalcemia was the most prevalent abnormality, seen in 57.6% of patients.
  • A significant association was found between electrolyte imbalance and increased mortality (91% of deaths) and prolonged PICU stay.

Conclusions:

  • Electrolyte imbalance serves as a critical prognostic indicator in critically ill children.
  • Early detection and management of electrolyte disturbances are vital for improving patient outcomes.
  • This study highlights the importance of routine electrolyte monitoring in the PICU.