Patterns of electrolyte abnormalities in children admitted to paediatric intensive care unit: An observational study

Background: Electrolytes are essential for maintaining physiological homeostasis, especially in critically ill paediatric patients who are more vulnerable to imbalances due to higher metabolic rates and sensitive organ systems. 
Objectives: To evaluate the prevalence, types, and clinical impact of dyselectrolytaemia in children admitted to a Pediatric Intensive Care Unit (PICU).
Method: A prospective observational study was conducted from August 1, 2023, to February 28, 2024, in the PICU of Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India. Children aged 1 month to 15 years admitted to the PICU were included, excluding those with known electrolyte disorders or brief stays. Blood samples were analysed using the VITROS 5600 system, and electrolyte levels were assessed at 24 and 72 hours, and before discharge. Statistical analyses included chi-square test, t-test, and Pearson/Spearman correlations using SPSS version 25.
Results: Among 120 patients (mean age 5.7 ± 4.98 years; 60% male), 68.3% exhibited electrolyte abnormalities. Hypocalcaemia (29.2%) was the commonest at admission, while hyperchloraemia persisted during hospitalization. Hyponatraemia was the most prevalent overall. Central nervous system involvement (30%) was the leading associated systemic condition. Electrolyte abnormalities significantly correlated with prolonged hospital stay (14.94 ± 8.94 vs. 6.86 ± 4.33 days, p <0.0001) and higher mortality (14.2%). Potassium, chloride, and calcium imbalances were notably linked to extended admissions.
Conclusions: Dyselectrolytaemia is common in critically ill paediatric patients and is associated with increased morbidity and longer PICU stay.