Mean difference of Electrolyte Level measured in Arterial Blood gases and measured in Laboratory in Children presenting in Pediatric Intensive Care Unit

Abstract

Background:  Electrolytes are measured in arterial and venous blood by arterial blood gas analyzer and the auto-analyzers respectively.

Objective: To determine the mean difference in electrolyte level in arterial blood gases (ABGs) level versus laboratory serum electrolyte level in the children admitted in the pediatric intensive care unit.

Methodology: This cross-sectional study was conducted at department of Pediatrics, the Children’s Hospital and Institute of Child Health, Lahore from 1^st December 2015 to 31^st May 2016. Total of 125 children fulfilling inclusion criteria were enrolled in the study from pediatric intensive care unit. The ABGs (whole blood) electrolytes were obtained immediately after collection, using ABGs analyzer. Serum electrolytes were analyzed in the central laboratory of the institution. Reports were assessed and levels of sodium and potassium was noted from reports of ABGs and laboratory.

Results: Mean NA⁺ value on ABGs and from laboratory was 134.66 and 132.26 (p= 0.01). Mean K⁺ value from on ABGs and from laboratory was 4.51 and 4.28. (p= 0.071). In age group 1-5 and 6-10 years, K⁺ level was high in ABGs value (p-value=0.065 & p-value=0.073). However, in age group 11-15 years K⁺  level was significantly higher in ABGs value as that of laboratory value (p-value=0.014). The same trend was observed in male and female children that mean NA⁺ and K⁺  value with ABGs was significantly higher as compared to that of laboratory value.

Conclusion: NA⁺ and K⁺  in arterial blood gases level were different from laboratory serum electrolyte level in children admitted to pediatric intensive care unit. Clinician should be aware of differences so that potential misdiagnosis does not occur and unnecessary treatment or investigation can’t be performed.