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


Electrolyte abnormalities


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Alauddin M, Khan MA, Amman A, Uddin G. Electrolyte Abnormalities in Neonates with Septicaemia: A Hospital-Based Study. Integr J Med Sci [Internet]. 2022 Mar. 2 [cited 2022 Jun. 30];9. Available from: https://mbmj.org/index.php/ijms/article/view/634


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.



Students’ Hand Book, IMCI-Integrated Management of Childhood illness. Revised print in Bangladesh. January 2008. Acknowledgement. [Accessed 2022 Mar 01]. Available from: https://apps.who.int/iris/bitstream/handle/10665/42939/9241546441.pdf?sequence=1&isAllowed=y

Bangladesh Demographic and Health Survey 2007. Preliminary Report; 2009: 25-26. [Accessed 2022 Mar 01]. Available from: https://dhsprogram.com/pubs/pdf/FR207/FR207[April-10-2009].pdf

Duke T. Neonatal pneumonia in developing countries. Arch Dis Child Fetal Neonatal Ed. 2005; 90(3): F 211-F219. https://doi.org/10.1136/adc.2003.048108

Hossain MM, Mannan MA, Shahidullah M. Pattern of admissions and morbidity with outcome of neonates admitted in tertiary level hospital in Bangladesh. SOUVENIR, 6th National Conference; Bangladesh Neonatal Forum: 2010.

Annual Report 2008. Department of pediatrics, Dhaka Medical College Hospital; 9.

Hossain MM, Shirin M, Mamun AA. Electrolyte Abnormalities in Neonates Admitted in Intensive Care Unit. Bangladesh J Child Health. 2004; 28: 13-17.

Rao SDS, Thomas B. Electrolyte Abnormalities in Children Admitted to Pediatric Intensive Care Unit. Indian Pediaric. 2000; 37(12): 1348-53.

Chawla D, Agarwal R, Deorari AK. Fluid and Electrolyte Management in Term and Preterm Neonates. Indian J Pediatr. 2008; 75(3): 255-9. https://doi.org/10.1007/s12098-008-0055-0

Modi N. Hyponatremia in the newborn. Arch Dis Child Fetal Neonatal Ed.1998; 78(2): F81-4. https://doi.org/10.1136/fn.78.2.f81

Rees L, Brook CGD, Shaw JCL. Hyponatremia in the first week of life in preterm infants. Part-I Arginine Vasopressin secretion. Arch Dis Child. 1984; 59(5): 414-22. https://doi.org/10.1136/adc.59.5.414

Easterbrook PJ. Renal Physiology. In: Easterbrook PJ, editor. Basic Medical Sciences for MRCP Part 1. 3rd ed. London: Elsevier Churchill Livingstone: 2005;198-200.

Barrett KE, Boitano S, Barman SM, Brooks HL. Regulation of Extracellular Fluid composition and volume. Ganong’s Review of Medical Physiology. 23rd ed. New York: The McGraw-Hill companies: 2010; 665-678.

Gomella TL, Cunningham MD, Eyal FG. Body Water, Fluid and Electrolytes. Neonatology: Management, Procedures, On-call Problems, Diseases and Drugs. 6th ed. USA: The McGraw-Hill Companies: 2009; 68-75.

Greenbaum LA. Electrolyte and Acid-Base Disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th edition. Philadelphia: Saunders, Elsevier: 2007; 267-309.

Singhi S, Prasad SVSS, Chung KS. Hyponatremia in sick children, a marker of seruous illness. Indian pediatr. 1994; 31:19-24. [Accessed 2022 Mar 01]. Available from: https://www.indianpediatrics.net/jan1994/19.pdf

Bhat SR, Lewis P, Dinakar C. Hypernatremic Dehydration in a neonate. Indian Pediatr. 2001; 38: 1174-7. [Accessed 2022 Mar 01]. Available from: https://www.indianpediatrics.net/oct2001/oct-1174-1177.htm

Singhi S, Gulati S, Prasad SV. Frequency and Significance of Potassium Disturbances in Sick Children. Indian Pediatr 1994; 31(4): 460-3.

Ambalavanan N. Fluid, electrolyte and nutrition management of the newborn. Medscape. 2018. [Accessed 2022 Mar 01]. Available from: https://emedicine.medscape.com/article/976386-overview

Tollner U. Early diagnosis of septicaemia in the newborn: Clinical studies and sepsis score. Eur J Pediatr. 1982; 138(4): 331-7. https://doi.org/10.1007/bf00442511

Afroza S, Begum F. Co-relation between sepsis score and blood culture report in neonatal septicaemia. J Banglad Colleg Phys Surg. 2008; 26:79-82. https://doi.org/10.3329/jbcps.v26i2.4185

Peter D. Infection in the newborn. In: Rennie JM, Reberton’s NRC, eds. Textbook of Neonatology. 4th ed. London: Elsevier Churchill Livingstone: 2005; 1017-18.

Srivastava RN, Bagga A. Electrolyte and Acid Base Disorders. In: Srivastava RN, Bagga A, eds. Pediatric Nephrology. 4th ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd: 2005; 81-105.

Berry PL, Belsha CW. Hyponatremia. Pediatr Clin N Am. 1990; 37(2):351-63. https://doi.org/10.1016/s0031-3955(16)36873-0

Schoen EJ, Bhatia S, Ray GT, Clapp W, To TT. Transient pseudohypoaldosteronism with hyponatremia hyperkalemia in infant urinary tract infection. J Urol. 2002; 167(2 pt 1):680-82. https://doi.org/10.1097/00005392-200202000-00063

Conley SB. Hypernatremia. Pediatr Clin N Am. 1990; 37(2):365-71. https://doi.org/10.1016/s0031-3955(16)36874-2

Brem AS. Disorders of potassium homeostasis. Pediatr Clin North Am. 1990; 37(2):419-27. https://doi.org/10.1016/s0031-3955(16)36877-8

Marudkar A, Singhi S. Hypokalemia in pediatric intensive care unit. Indian pediatr. 1996; 33(1):9-14.

Mandal AK, Saklayan MG, Hillman NM, Market RJ. Predictive factors for high mortality in hypernatraemic patients. Am J Emergency Med. 1997; 15(2):130-2. https://doi.org/10.1016/s0735-6757(97)90082-6

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Copyright (c) 2021 Aminul Islam, Mohammad Alauddin, Mohammad Azam Khan; Abdullahel Amman; Md. Gias Uddin


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