Electrolyte Imbalances in Children Admitted to the Pediatric Emergency Department

Abstract

Introduction: Electrolyte imbalances in pediatric patients can range from mild to severe. These disorders can be caused by underlying diseases or the inappropriate use of intravenous solutions,  particularly in hospitalized patients who are fasting.

Methods: A prospective cohort study was conducted from January 2023 to September 2024 at the Nuevo Hospital Civil de Guadalajara Dr. Juan I Menchaca (HCGJIM), Jalisco, México. Patients aged 1 month to 17.9 years who were admitted to the emergency department and fasted were included, with follow-up from admission until 48 hours. A non-probability sampling method was used for consecutive cases. Frequencies and percentages were estimated for qualitative variables, and means and standard deviations were obtained for quantitative variables.

Results: 423 patients were included; 56.7% were male. The median age was 4 years (IQR 8). Upon admission, the most common electrolyte imbalances were hyponatremia (19.4%) and hypocalcemia (18.4%). The main cause of admission was infectious disease (34%, n= 144). The most frequently used intravenous maintenance solution was Hartmann's solution (54.6%). After 12 hours of fasting, significant changes in potassium and chloride were observed. At 24 and 48 hours, changes were seen in calcium, potassium, and chloride.

Conclusion: In hospitalized patients who are fasting, monitoring serum electrolytes is recommended due to the frequency of electrolyte imbalances. Furthermore, basal electrolyte requirements, according to age, should be added to maintenance solutions.