MD. Physician, Pediatric Nephrologist in Division of Pediatric Nephrology, Department of Pediatrics, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey.
MD. Physician, Pediatric Intensivist in Division of Pediatric Intensive Care Unit, Department of Pediatrics, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey.
Sao Paulo Med J. 2024 Mar 8;142(4):e2022370. doi: 10.1590/1516-3180.2022.0370.R2.010923. eCollection 2024.
Hyperchloremia is often encountered due to the frequent administration of intravenous fluids in critically ill patients with conditions such as shock or hypotension in the pediatric intensive care unit, and high serum levels of chloride are associated with poor clinical outcomes.
This study aimed to determine the association between hyperchloremia and in-hospital mortality in pediatric patients with major trauma.
This retrospective cohort study was conducted at a tertiary university hospital in Turkey.
Data were collected between March 2020 and April 2022. Patients aged 1 month to 18 years with major trauma who received intravenous fluids with a concentration > 0.9% sodium chloride were enrolled. Hyperchloremia was defined as a serum chloride level > 110 mmol/L. Clinical and laboratory data were compared between the survivors and nonsurvivors.
The mortality rate was 23% (n = 20). The incidence of hyperchloremia was significantly higher in nonsurvivors than in survivors (P = 0.05). In multivariate logistic analysis, hyperchloremia at 48 h was found to be an independent risk factor for mortality in pediatric patients with major trauma.
In pediatric patients with major trauma, hyperchloremia at 48-h postadmission was associated with 28-day mortality. This parameter might be a beneficial prognostic indicator.
在儿科重症监护病房中，由于休克或低血压等情况，危重症患者经常需要静脉补液，因此经常会出现高氯血症，而高血清氯水平与不良临床结局相关。
本研究旨在确定高氯血症与重大创伤儿科患者住院死亡率之间的关系。
这是一项在土耳其一家三级大学医院进行的回顾性队列研究。
研究数据收集于 2020 年 3 月至 2022 年 4 月期间，纳入接受浓度>0.9%氯化钠静脉补液的年龄在 1 个月至 18 岁的重大创伤患儿。高氯血症定义为血清氯水平>110mmol/L。比较存活者和非存活者的临床和实验室数据。
死亡率为 23%（n=20）。非存活者中高氯血症的发生率明显高于存活者（P=0.05）。多变量逻辑分析显示，入院后 48 小时的高氯血症是重大创伤儿科患者死亡的独立危险因素。
在重大创伤的儿科患者中，入院后 48 小时的高氯血症与 28 天死亡率相关，该参数可能是有益的预后指标。
