Abstract P-326: HYPERCHLOREMIA IN CRITICALLY ILL PEDIATRIC PATIENTS, THE “HYCCIP” STUDY

Bulfon, A.; Stef, Sorina A.; Alomani, H.; Comrie, Brooke T.; Vanniyasingam, Thuva; Zheng, Katina; Laskey, S.; Panchal, Puru; Bram, R.; Natalie, A August; Choong, Karen

doi:10.1097/01.pcc.0000537783.94346.55

Cited by 1 publication

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“…This has undergone a change from hypotonic fluid to isotonic maintenance fluids to avoid symptomatic hyponatraemia 13 . However, the use of isotonic fluids such as 0.9% NS has the potential to give rise to hyperchloraemia 2,3,4 . We analysed 118 children admitted in PICU/HDU who received at least 20ml/kg of 0.9% NS bolus during resuscitation in the first 6 hours of admission followed by maintenance fluid based on unit protocol; 22.9% children developed hyperchloraemia.…”

Section: Discussionmentioning

confidence: 99%

“…The chloride levels started to rise after 6 hours of NS bolus and continued to show the rising trend with highest values at 48 hours. The various studies in the past have shown a prevalence of hyperchloraemia from 16.6 to 94.9% in children [2][3][4][5][11][12][13] .…”

Section: Discussionmentioning

confidence: 99%

“…In hyperchloraemia there is elevation of chloride ions more than 110mEq/L [1][2][3][4][5] . Mechanisms leading to the development of hyperchloraemia include excessive chloride administration, water loss in excess of chloride loss and increased renal reabsorption of chloride 6 .…”

Section: Introductionmentioning

confidence: 99%

“…The chloride content varies with the composition of different fluids. Hyperchloraemia predisposes to non-anion gap metabolic acidosis which may result in an adverse outcome 2,3 . Studies have shown the development of acute kidney injury (AKI) in association with hyperchloraemia 2,5,8 .…”

Section: Introductionmentioning

confidence: 99%

“…Hyperchloraemia predisposes to non-anion gap metabolic acidosis which may result in an adverse outcome 2,3 . Studies have shown the development of acute kidney injury (AKI) in association with hyperchloraemia 2,5,8 . Poor outcomes have been noted with use of chloride-rich fluids in patient with diabetic ketoacidosis 9,10 and septic shock 11 .…”

Section: Introductionmentioning

confidence: 99%

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Blood chloride levels in children given 0.9% normal saline as fluid for resuscitation followed by isotonic maintenance fluid

Gaurav

John

Dhingra

2022

Sri Lanka J Child Health

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Background: In the last few years there have been several studies describing the occurrence of hyperchloraemia following the use of isotonic fluids. These studies have shown variable results with respect to its prevalence and outcomes. Studies in the paediatric population have been sparse. Objectives:To study the prevalence of hyperchloraemia in the first 48 hours in children who received 0.9% normal saline as fluid for resuscitation and to assess the relationship of hyperchloraemia with outcomes such as use of inotropes, acute kidney injury (AKI), length of stay and mortality. Method:A cross-sectional study was conducted in the department of paediatrics of a tertiary care hospital; 118 children who were admitted in the paediatric intensive care unit / high dependency unit were enrolled in the study. Blood chloride levels were checked at 0-6 hours, 12-24 hours and 24-48 hours. Data analysis was done using SPSS software version 16 and Microsoft Excel 2007.Results: Mean age of the sample population was 5.45 ± 3.97 years with 52% of them being boys; 22.9% children developed hyperchloraemia. There were significant differences in chloride levels between the hyperchloraemia and normochloraemia groups at all three-time frames (p=0.000). The chloride levels ___________________________________________ 1 Junior Resident,

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