Evaluation of Serum Electrolytes in Traumatic Brain Injury Patients: Prospective Randomized Observational Study

Abstract

Background: Traumatic brain injuries (TBI) are the major public health problem and devastating condition, with significant mortality and morbidity. Electrolyte imbalance after resuscitation in TBI patients are common and further aggravate this condition. The main objectives are prevention and treatment of intracranial hypertension and secondary brain insults, preservation of cerebral perfusion pressure (CPP), and optimization of cerebral oxygenation. Proper in time detection followed by appropriate management not only improves neurological status but also decrease morbidity and mortality. Aim:We evaluate the electrolyte derangement in traumatic brain injury patients 24 hour after resuscitation.Method: After Institutional Ethical approval and written informed consent, all TBI patients meeting inclusion criteria were included in this prospective observational study. Serum electrolytes (serum sodium, potassium, calcium and phosphate) were measured at time of admission and 24 hour after resuscitation. All patients received standard treatment according to institutional protocol for TBI patients.Result: Hypernatremia (27.30%) is the most common electrolyte abnormality followed by hyponatremia (18.73%), Hypokalemia (21.58%), Hyperkalemia (17.77%), hypocalcaemia (11.4%), Hyperphosphatemia (9.8%) followed hypophosphatemia (4.8%) within the first 24 hours after resuscitation. Conclusion:Electrolyte imbalance following traumatic head injury is an important cause to look for in patient monitoring. Sodium is the chief electrolytes of concern. Serum potassium, calcium and Phosphate levels also under goes notable changes. Based on CT scan findings several traumatic brain injuries associated with various electrolytes derangements are of important concern especially with in first 24 hours after resuscitation.

Evaluation of Electrolyte Imbalance in Patients With Traumatic Brain Injury Admitted in the Central ICU of a Tertiary Care Centre: A Prospective Observational Study

“…Other important electrolyte deficiencies noted were hypocalcaemia, hypophosphatemia, and hypomagnesemia. This was consistent with the study by Gupta et al [10], Suman S et al [12].…”

Recognition and Prevention of Hospitalised Malnutrition: A Case Report

“…In critically ill patients, these abnormalities can be attributed to multiple factors, such as hepatic ischaemia, sepsis, drugs, and artificial nutrition. Even though literates showed an association of abnormal LFTs with mortality outcomes and clinical events on ICU, this cannot be extrapolated for patients with TBI [34,35]. Finding elevated liver enzymes usually prompts a cascade of diagnostic testing to include repeat serum analysis, imaging, and potentially invasive testing such as biopsy.…”

“…Secondly, albumin and pre-albumin are consistent markers of sepsis, so hypoalbuminemia was predominantly seen as patients developed septicaemia during their course of stay in ICU. And thirdly, patients with traumatic brain injury are frequently hyper-metabolic and hypercatabolic; demonstrate many aspects of acute phase response, and often have depressed albumin concentration on admission and throughout much of their course of admission [35][36][37]41].…”

Initial Serum Levels of Magnesium and Calcium as Predictors of Mortality in Traumatic Brain Injury Patients: A Retrospective Study

“…Traumatic brain injury (TBI) remains as one of the most serious global public health challenges due to associated high case fatality, long-term disability, and socioeconomic burden [ 1 , 2 , 3 , 4 ]. Electrolyte imbalances in terms of abnormalities in serum sodium, potassium, calcium, and/or phosphate are common findings in TBI patients [ 5 , 6 ]. The most frequent cause of death following traumatic injury continues to be uncontrolled exsanguinating hemorrhage [ 7 ].…”