Electrolyte Abnormalities in Neonates with Probable and Culture-Proven Sepsis and its Association with Neonatal Mortality

Abstract

Objective: To ascertain the frequency of electrolyte abnormalities in patients of probable and culture-proven sepsis on admission and assess any association of electrolyte disorders with mortality.

Study design: Descriptive study.

Place and duration of study: NICU, Fazle-Omar Hospital, Rabwah, from October 2015 to September 2016.

Methodology: All neonates with the diagnosis of probable and culture-proven sepsis during the study period admitted in NICU, Fazle-Omar Hospital, were included in the study. Electrolyte levels were categorised as normal, high or low and recorded in the data form, with age and outcome. Fisher exact test was used to test association. SPSS 20 was used for data analysis.

Results: One hundred and fifty-one neonates were included in the study. Ten (6.6%) died. Among these, 114 (75.49%) had one or more electrolyte abnormalities. Median (IQR [interquartile range]) levels of sodium and chloride were, 140 (7.1), and 100.2 (7.4) mmol/L, respectively. Mean levels of potassium and calcium were 5.07 ±0.76 mmol/L and 2.35 ±0.338 mmol/L, respectively. Hyperkalemia was the commonest electrolyte disorder present in 60 (39.7%) neonates, followed by hypercalcemia in 50 (33.1%) and hypocalcemia in 20 (13.2%). None of the neonates without any electrolyte abnormality died (p=0.053).

Conclusion: Majority cases of neonatal sepsis have got electrolyte abnormalities. Hyperkalemia was the commonest electrolyte imbalance followed by hypercalcemia and hypocalcemia.