Acid-base disorders in critically ill neonates.

OBJECTIVE

To study acid-base imbalance in common pediatric diseases (such as sepsis, bronchopneumonia, diarrhea, birth-asphyxia etc.) in neonates.

DESIGN AND SETTING

An observational study was conducted in an emergency room of a tertiary teaching care hospital in Haryana, India.

PATIENTS AND METHODS

Fifty neonates (from first hour to one month) attending pediatric emergency services with various ailments. Blood gas analysis, electrolytes, plasma lactate, and plasma albumin were estimated in neonates.

RESULTS

Metabolic acidosis was the most common acid-base disorder. Hyperlactatemia was observed in more than half of such cases. Birth asphyxia was another common disorder with the highest mortality in neonates followed by bronchopneumonia and sepsis. Significant correlation between mortality and critical values of lactate was observed.

CONCLUSION

Birth asphyxia with high-lactate levels in neonates constituted major alterations in acid-base disorders seen in an emergency room of a tertiary teaching care hospital. Plasma lactate concentration measurement provides an invaluable tool to assess type of metabolic acidosis in addition to predicting mortality in these neonates.