Metabolic disorders in acute infectious diarrhea in children

Abstract

The purpose of the study: estimate the frequency of registration of different types of acid-base state disorders in children with acute infectious diarrhea; to determine the clinical features of acute intestinal infections that occur with metabolic acidosis (MA) and without it to choose the tactics of effective correction. Мaterials and methods : retrospective cohort study was conducted of 246 patients hospitalized in a hospital with clinic of acute infectious diarrhea. Results of the study : laboratory-confirmed acidosis, were recorded in 40.7% (95% CI 34.6–46.8), 100/246 children, incl. With a pH below 7.25 in 9.3% (95% CI 5–7–12.9), 23/246. The condition of alkalosis revealed in 4.9% (95% CI 2.2–7.6) of 12/246 examined. Hyperchloremic acidosis had a place in 81% (95% CI 73.3–88.7), 81/100 patients, with a high anionic deficiency in 19% (95% CI 11.3–26.7), 19/100, P <0.001. Decompensated MA with pH <7.25 was recorded in 6.2% (95% CI 0.9–11.5), 5/81 examined with hyperchloremic acidosis and in 94.7% (95% CI 84.6–104, 8), 18/19 – with keto- and lactate-acidosis. Subcompensated MA was more often detected with rotavirus infection, RVI (50.6% (95% CI (39.4–61.8), 39/77), p <0.001. Metabolic disorders with RVI were more likely to correspond to acidosis with a high anion gap (52, 6% (95% CI 30.1–75.1) 10/19, p=0.02.) Bacterial diarrheas were more often observed in children without disturbances of the KHS (22.4% (95% CI 15.3–29, 5), 30/134), p=0.014. In assessing the characteristics of different types of MA we identified that the presence of tachypnea increases the probability of detecting acidosis with a high anion gap of 3.5 times (OR 3.5 CI 1.3–9.3). Conclusion : Our studies didn’t reveal pathognomonic clinical symptoms of various variants of metabolic acidosis.