Electrolyte Abnormalities in Neonates with Septicaemia: A Hospital-Based Study

M. Alauddin, Mohammad Azam Khan, Abdullahel Amman, Giass Uddin
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Abstract

Introduction: Despite the continuing struggle, Bangladesh's under-five mortality rate is still high. However, Bangladesh has achieved a significant reduction in childhood mortality from 173 per thousand. The high level of neonatal deaths in Bangladesh is a great concern among all health professionals. Objective: To determine the frequency and pattern of electrolytes imbalance in neonates with septicaemia and their impact on mortality and morbidity. Methods: All neonates suffering from septicaemia and admitted to BSMMU from 1st January 2011 to 15th September 2011 and fulfilled the inclusion criteria were evaluated. Results: During the study period total of 120 neonates were admitted with the diagnosis of septicaemia in the Department of Neonatology, BSMMU, Dhaka, Bangladesh. Among the neonates, mean age was 9.26±4.58 days, mean weight 2282.68±580.40 gm, mean gestational age 35.68±2.40 weeks, males were 66 (55%), and females were 54 (45%). Electrolyte abnormalities were found in 42 (35%) neonates with septicaemia. Among the electrolyte abnormalities, hyponatremia was found in 24 (20%) neonates, hypernatremia in 12 (10%), hypokalemia in 17 (14.2%), hyperkalemia in 19 (15.8%), and mixed abnormalities in 18 (15%) cases. Neonates with dyselectrolytemia were found significantly associated with prolonged hospital stay compared to those with normal electrolyte levels (p< 0.05). Hyponatremia, hypokalemia, and mixed electrolyte abnormalities were significantly associated with higher mortality (p<0.05). But hypernatremia and hyperkalemia were not significantly associated with higher mortality (p> 0.05). Conclusion: Electrolyte abnormalities are common in neonates with septicaemia. They contribute considerably to the higher mortality and prolonged hospital stay of neonates irrespective of the primary disease.
新生儿败血症的电解质异常:一项基于医院的研究
导言:尽管继续进行斗争,孟加拉国五岁以下儿童死亡率仍然很高。然而,孟加拉国已将儿童死亡率从千分之173大幅降低。孟加拉国新生儿死亡率高是所有卫生专业人员非常关注的问题。目的:了解新生儿败血症患者电解质失衡的频率和模式及其对死亡率和发病率的影响。方法:对2011年1月1日至2011年9月15日在BSMMU住院的所有败血症新生儿进行纳入标准评估。结果:在研究期间,共有120名新生儿在孟加拉国达卡BSMMU新生儿科被诊断为败血症。新生儿平均年龄9.26±4.58天,平均体重2282.68±580.40 gm,平均胎龄35.68±2.40周,男66例(55%),女54例(45%)。42例(35%)败血症新生儿发现电解质异常。电解质异常中,低钠血症24例(20%),高钠血症12例(10%),低钾血症17例(14.2%),高钾血症19例(15.8%),混合性异常18例(15%)。与电解质水平正常的新生儿相比,患有电解质障碍的新生儿住院时间延长显著相关(p< 0.05)。低钠血症、低钾血症和混合电解质异常与高死亡率显著相关(p < 0.05)。结论:新生儿败血症中电解质异常较为常见。它们在很大程度上导致了新生儿死亡率的升高和住院时间的延长,无论其原发疾病如何。
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