Evaluation of the Pattern of Electrolyte Disturbances in Patients Admitted in ICU

Background: Electrolyte and acid base disturbances are major responsible factors for leading complications in intensive care unit (ICUs) in conditions like Diabetes Mellitus, acute or chronic renal failure, acute or chronic respiratory failure, sepsis and cardiovascular diseases etc. Thus, present study was planned to evaluate the pattern of electrolyte disturbances in ICU patients. Material and Method:The present study was conducted at University Medical College with tertiary Care Hospital. It was Retrospective Cross sectional study. Study protocol was approved by Institutional Ethics Committee. Study was conducted during period ofApril 2018 to August 2018. Total Seventy-eight (78) cases admitted in ICU department were included in present study with following inclusion and exclusion criteria.Patients admitted in ICU department with their history, physical and clinical examinations and age above 18 years of both genders with Conditions like Diabetes Mellitus, Renal failure (Except dialysis patient), Sepsis, Cardiovascular disease and Cerebrovascular diseases were included in the study. Patient admitted in ICU having other conditions like Neuromuscular disorders, Semi-comatose and comatose state, Unwilling for participation and Patients on potassium diuretics were excluded from the study.Data was obtained by laboratory measurement of Serum Electrolyte levels (sodium, potassium, chloride) by using Electrolyte analyzer and from ICU for measurement of ionized calcium by ABG (Arterial Blood Gas) analyzer. Period of ICU stay was analyzed by date of ICU admission to date of discharge from ICU. Electrolytes were analyzed by using Prolyte Electrolyte Analyzer with ion selective electrode (Diamond Diagnostic: Prolyte 1- Na+K+Cl-L+ and ABG analyzer- Na+K+iCa++).Commercially available Fluid pack was Used for electrolyte measurement. This facility was available at Central Clinical Laboratory and ICU of our hospital.Data were compiled and analyzed using SPSS Software with version 28.0 for statistical analysis such as Paired “t test” , ANOVA test used to compare mean difference electrolyte levels among disease group and Pearson's Correlation coefficient to find out the correlation between hospital stay with electrolyte level. Results:Sodium showed statistically significant (p value <0.001) difference between patients at admission and at discharge amongst other electrolyte values.Positive correlation was found in potassium values compared to other electrolytes in case of period of stay by using Pearson's correlation coefficient. Conclusion:From this present study we can conclude that average 6 to 7 days of ICU stay is essential for managing electrolyte disturbances such as sodium and chloride. But Potassium and Ionized calcium need more ICU stay to manage disturbances? Implication: The study outcome will help the clinicians to identify common pattern of electrolyte imbalance and such pattern of electrolyte will help to decide period stay of patient in ICU.