Electrolyte disorders in the critically ill: a retrospective analysis.

Area of Science:

• Critical Care Medicine
• Clinical Chemistry
• Nephrology

Background:

• Electrolyte imbalances are linked to poor outcomes, but data on multiple disorders and interactions are limited.
• Understanding these complex electrolyte disturbances in intensive care unit (ICU) patients is essential.

Purpose of the Study:

• To determine the prevalence, incidence, and interactions of electrolyte disorders in ICU patients.
• To analyze the impact of intravenous electrolyte administration and identify risks of overcorrection.

Main Methods:

• Retrospective analysis of 2,056 adult ICU patients' electrolyte levels and intravenous fluid administration within the first 96 hours.
• Descriptive statistics, regression models, and AUC-ROC analysis were employed.

Main Results:

• Over 38% of patients had multiple electrolyte disorders on admission; 77.4% developed new disorders during their ICU stay.
• Hyperchloremia, hyperkalemia, hypophosphatemia, and hyperphosphatemia were most common. Significant interactions between electrolyte levels were observed.
• Electrolyte overcorrection occurred in 24.4% for hypokalemia and 8.7% for hypophosphatemia. Specific time and dosage cut-offs for potassium and phosphate were identified.

Conclusions:

• Electrolyte disorders are highly prevalent and interconnected in ICU patients.
• Intravenous electrolyte administration carries a risk of overcorrection, necessitating precise protocols.
• Establishing safe administration guidelines based on identified cut-off points is recommended.