Frequency of metabolic acidosis in children admitted to pediatric intensive care unit of a tertiary care hospital, Karachi: Prospective observational cohort study

Abstract

Objective: Metabolic acidosis (MA) is the most frequent acid-base disorder in the pediatric intensive care unit (PICU). The aim of this study is to determine the frequency of MA in children on admission in the first 24 h of PICU. Methods: A prospective observational cohort study was conducted in a closed PICU from August 2015 to June 2016. All consecutive children who admitted to PICU were screened for MA. MA is defined as base deficit (BD) ≥−5 mEq/l. Demographic data, clinical variables, and blood gas data were collected on structured data collection sheet and appropriate statistical test applied for analysis. Results: A total of 200 children were enrolled in the study. The mean age was 63.20 ± 61.31 months and males were 56%. The frequency of MA in our cohort was 44%. The mean BD was 10.4 ± 4.9 in a group of MA as compared to −2.34 ± 5.4 in group without MA. The use mechanical ventilation, inotropic support, and renal support were higher in MA cohort as compared to cohort without MA. The mortality rate was also high in group of MA as compared to other groups (25% vs. 12.5%) (P = 0.014). Conclusion: The frequency of MA is high in critically ill children on admission to PICU, and it is associated with increased length of stay and high mortality rate.