Electrolyte disturbances in children admitted at pediatric intensive care unit in BP Koirala institute of health sciences: A cross-sectional observational study

Objective: To investigate the types and clinical implications of electrolyte disturbances, specifically focusing on serum sodium, potassium, and calcium levels, in critically ill pediatric patients admitted to the Pediatric Intensive Care Unit (PICU) at B.P. Koirala Institute of Health Sciences (BPKIHS). Methods: This cross-sectional study included 188 critically ill children admitted to the PICU. Serum levels of sodium, potassium, and calcium were measured, and electrolyte disturbances were categorized. Data on baseline demographics, underlying conditions, and organ systems involved, and clinical outcomes were collected. Associations between electrolyte disturbances and patient outcomes were statistically analysed. Results: Hyponatremia was identified as the most common electrolyte disturbance, especially among patients with respiratory and gastrointestinal system involvement. Hypocalcemia was also prevalent and was significantly associated with gastrointestinal and endocrine conditions (p = 0.029 for total calcium, p = 0.039 for ionized calcium). The study found a strong association between normal levels of sodium and calcium and favourable clinical outcomes (p = 0.0127 for sodium, p = 0.002 for calcium). In contrast, hypernatremia and hypocalcemia were linked with adverse outcomes. Mixed electrolyte disturbances, particularly hyponatremia coupled with hyperkalemia or hypocalcemia, posed additional clinical management challenges. Conclusion: Electrolyte imbalances are common in critically ill pediatric patients and are closely linked with underlying disease states and outcomes. Routine monitoring and timely correction of electrolyte disturbances are critical to improving clinical outcomes in PICU patients. The study emphasizes the need for protocol-driven management strategies for electrolyte disturbances in pediatric critical care settings.