A STUDY OF ELECTROLYTES IMBALANCE IN MECHANICALLY VENTILATED PATIENTS

Abstract

Introduction: Mechanical ventilation is used to assist or replace spontaneous breathing. It is implemented with special devices that can support
ventilator function and improve oxygenation through the application of high-oxygen-content gas and positive pressure. Electrolytes and fluid
disorders are ubiquitous in critically ill patients especially who are mechanically ventilated. Electrolytes disturbance have great impact on outcome
during course and weaning from mechanical ventilation. This study is undertaken to evaluate the association between serum electrolytes changes
and mechanical ventilation and their possible impact on prognosis and outcome.
Aims & Objectives: To study the level of serum electrolytes in mechanically ventilated patients, To identify commonest electrolyte abnormality in
mechanically ventilated patients, To correlate its effects with patient outcome in terms of mortality
Materials and Methods: During the course of June 2018 to June 2019, total 100 subject requiring mechanical ventilation were undertaken
examined into this prospective study. Estimation of serum electrolytes including Na+, K+, Ca++ and Cl- were done before ventilation and after the 24
hour interval of ventilation. Obtained data were plotted in excel sheet. APACHE II score was counted at the interval of 24 hours.
Result: Out of 100 subjects, 55 were males with mean age of 46 ± 19 years and 45 were females with mean age of 42 ± 19 years. On comparison of
data of serum electrolytes collected before ventilation and at 24 hours of mechanical ventilation with paired T test, it is noticed that there is
statistically significant decrement in mean serum sodium, potassium and ionized calcium level at 24 hour interval of mechanical ventilation with
difference of 3.15, 0.484 and 0.0485 respectively and P value of <0.0001, <0.0001 and 0.0075 respectively. we observed an incidence of electrolyte
imbalance at the interval of 24 hours of mechanical ventilation in the form of Hypocalcemia (75%), Hyponatremia (45%), Hypokalemia (41%),
and Hypochloremia (41%).
Conclusion: Patients requiring on mechanical ventilation are at a higher risk of decrease in plasma Sodium, Potassium and Calcium(ionized) level.
Intensive treatment during the period of stay on mechanical ventilation added to the disease process itself can cause further deterioration in the level
of serum electrolytes. Imbalance of serum electrolytes and delay in time for its correction increase the period of mechanical ventilation, prolongs
the stay in critical setup and associated with increment of co-morbidity and mortality.