[Metabolic changes in critically ill children].
OBJECTIVE
Our aim was to analyze the incidence of metabolic disturbances in critically ill children and to evaluate their correlation with severity of illness, complications, mortality and length of hospital stay.


METHODS
We retrospectively studied 360 children who were admitted into a Pediatric Intensive Care Unit (PICU) between January 1995 and May 1996. We analyzed age, sex, initial diagnosis, complications, length of hospital stay and initial and final concentrations of serum glucose, calcium, phosphorus, magnesium and alkaline phosphatase.


RESULTS
The incidence of different metabolic disturbances at admission to the PICU was: hyperglycemia 51.9%, hypoglycemia 1.9%, hypocalcemia 24.5%, hypercalcemia 5.8%, hyperphosphatemia 7.3%, hypophosphatemia 7.9%, hypomagnesemia 47.4% and hypermagnesemia 3%. Patients with shock had lower concentrations of calcium and higher phosphorus levels, while children with sepsis had lower magnesium concentrations. Patients who died had a higher incidence of hyperphosphatemia and higher values of serum glucose and magnesium at admission, while patients who survived had lower concentrations of calcium and higher incidence of hypomagnesemia. We did not find any correlation between the initial values for metabolites and length of stay in the PICU.


CONCLUSIONS
Metabolic disturbances in critically ill children are frequent findings, correlate with important complications and can be prognostic markers. Thus, regular controls of different metabolites must be performed so we can precociously detect these disturbances and correct them.
Ruiz Magro
P
P
Unidad de Cuidados Intensivos Pediátricos, Ha General Universitario Gregorio Marañón, Madrid.
Aparicio López
C
C
López-Herce Cid
J
J
Martínez Campos
M
M
Sancho Pérez
L
L
D000293:Adolescent; D001927:Brain Diseases / Q000150:complications; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008659:Metabolic Diseases / Q000175:diagnosis* / Q000209:etiology; D009104:Multiple Trauma / Q000150:complications; D012016:Reference Values; D012140:Respiratory Tract Diseases / Q000150:complications; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications