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Electrolyte Disorders in the PICU

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Pediatric Critical Care Medicine

Abstract

Only a small fraction of acutely ill children are hospitalized with an electrolyte disorder as their primary diagnosis. However, many patients encounter secondary homeostatic imbalances that involve one or more of the following: sodium, potassium, calcium, magnesium and phosphorous. Abnormalities in the serum concentrations of these electrolytes could result from an underlying disease process; however, more frequently they are the result of complications, end organ injury or iatrogenic interventions such as fluid and electrolyte therapy, medications, or applications of critical care technology (positive pressure ventilation or renal replacement therapy), and should therefore be anticipated and prevented. Because of the fragile state of many of the pediatric intensive care unit (PICU) patients, electrolyte imbalances may have profound effects on patient outcomes, and in their extreme forms may be life-threatening. Careful, stepwise management is essential, as aggressive correction may at times result in further injury. This chapter outlines the pathophysiology and management of electrolyte disorders in the PICU. The authors have attempted to include a practical diagnostic and therapeutic approach to the most common disorders, but also provide a comprehensive differential diagnosis that would enable the practicing clinician to capture less common etiologies for electrolyte abnormalities in critically ill children.

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Authors and Affiliations

  1. Pediatrics, Pharmacology and Physiology, Department of Pediatrics, Critical Care and Pulmonary Medicine, Medstar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC, 20007, USA

    Gabriel J. Hauser MD, MBA

  2. Nephrology and Endocrinology, 5171 Liberty Ave, Pittsburgh, PA, 15224, USA

    Aaron F. Kulick MD

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  1. Gabriel J. Hauser MD, MBA
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Correspondence to Gabriel J. Hauser MD, MBA .

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Editors and Affiliations

  1. Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA

    Derek S. Wheeler

  2. Div. of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA

    Hector R. Wong

  3. MICHR, University of Michigan Medical Scho, Ann Arbor, Michigan, USA

    Thomas P. Shanley

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Hauser, G.J., Kulick, A.F. (2014). Electrolyte Disorders in the PICU. In: Wheeler, D., Wong, H., Shanley, T. (eds) Pediatric Critical Care Medicine. Springer, London. https://doi.org/10.1007/978-1-4471-6416-6_13

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