Introduction: Fluid and electrolyte disorders can be affected by various conditions or diseases. Electrolyte disorders are often found in pediatric patients with critically ill conditions and are associated with increased morbidity also mortality that requires extra care in the Pediatric Intensive Care Unit (PICU). Objective: To describe the electrolyte profile of critically ill patients with electrolyte disorders admitted to the Pediatric Intensive Care Unit (PICU) Dr. Soetomo General Hospital. Materials and Methods: The study was conducted prospectively with a descriptive method in patients with electrolyte disorders aged 1 month -18 years old admitted to PICU Dr. Soetomo General Hospital, Surabaya in a period from August to November 2018. Data on patient age, gender, electrolyte profile (sodium, potassium, calcium, chloride), and origin before PICU admission were recorded. Results and Discussion: From 37 patients with electrolyte disorders showed that patients were dominated by the male in 56.8% (n=21), in the age group of infants or 1-12 months old in 45.9% (n=17). Common main diagnosis in most patients were digestive system disorders in 27% (n=10), followed by central nervous system, respiratory system, kidney and cardiovascular disorders, and the origin before PICU admission were from Emergency Room (ER) in 62.2% (n=23). There were found 97 incidences of electrolyte disorders. Most frequent electrolyte disorders were hypocalcemia in 59.5% (n=22), hypokalemia in 54.1% (n=20), hyponatremia in 40.5% (n=15) and the least was hypochloremia in 35.1% (n=13). Mean serum sodium level was 138.18 ± 12.071, serum potassium level was 3.608 ± 1.2247, serum calcium level was 8.057 ± 1.9473 and serum chloride level was 101.45 ± 13.266. Conclusions: Critically ill patients admitted in PICU tend to experience low electrolyte levels. ABSTRAK Pendahuluan: Gangguan cairan dan elektrolit dapat dipengaruhi oleh berbagai kondisi atau penyakit. Gangguan elektrolit sering ditemukan pada pasien anak dengan kondisi sakit kritis dan dikaitkan dengan peningkatan morbiditas serta mortalitas yang memerlukan perawatan ekstra di Pediatric Intensive Care Unit (PICU). Tujuan: Untuk menggambarkan profil elektrolit pada pasien sakit kritis yang dirawat di PICU RSUD Dr. Soetomo, Surabaya. Metode dan Bahan: Penelitian ini dilakukan secara prospektif dengan metode deskriptif pada pasien dengan gangguan elektrolit berusia 1 bulan -18 tahun yang dirawat di PICU Rumah Sakit Umum Daerah (RSUD) Dr. Soetomo, Surabaya dalam periode dari bulan Agustus 2018 hingga November 2018. Data berupa usia, jenis kelamin, profil elektrolit serum (natrium, kalium, kalsium, klorida), dan asal pasien dicatat. Hasil dan Pembahasan: Dari 37 pasien, menunjukkan bahwa pasien didominasi oleh laki-laki sebesar 56,8% (n = 21), pada kelompok usia bayi atau usia 1-12 bulan sebesar 45,9% (n = 17). Diagnosis utama terbanyak pada pasien adalah gangguan sistem pencernaan sebesar 27% (n = 10), diikuti oleh gangguan sistem saraf, pernapasan, ginjal, dan sistem kardiovaskular. Asal pas...
Background: Ketogenic diet is a high lipid, low carbohydrate, and adequate protein diet. It has long been used as a therapy in refractory epilepsy patients, but very little is known about the long-term effects. Objectives: This study was conducted to analyze the effect of a ketogenic diet on carotid artery thickness and elasticity in patients with epilepsy. Discussion: Literature searches were conducted through search engines such as PubMed, ScienceDirect, and Google Scholar, resulting in four studies that were eligible for inclusion and have passed the selection process based on PRISMA flowchart and JBI critical appraisal. These studies involved patients with refractory epilepsy (13 months to 31 years old), who were given ketogenic diet therapy for at least 6 months. Carotid artery elasticity decreased significantly on the ketogenic diet given for 12 months (p<0.001). However, it was not accompanied by a significant change in wall thickness, which was assessed through carotid intima-media thickness (CIMT). Most studies found an increased cardiovascular risk due to an increase in lipid profile and carotid artery stiffness. Conclusions: In conclusion, the ketogenic diet affects the carotid artery elasticity without changing the thickness, also increases lipid levels reversibly, and is thought to increase cardiovascular risk in patients with refractory epilepsy.
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