TỶ LỆ VÀ MỘT SỐ YẾU TỐ LIÊN QUAN ĐẾN TÌNH TRẠNG TĂNG CLO MÁU Ở BỆNH NHÂN SỐC NHIỄM TRÙNG TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Objectives: To determine the proportion and some factors related to hyperchloremia in children
with septic shock at the Vietnam National Hospital of Pediatrics. Subjects and methods: Retrospective
and prospective description, including 94 patients diagnosed with septic shock at the Intensive Care
Unit of the Vietnam National Hospital of Pediatrics. Monitor clinical and laboratory characteristics, volume and type of fluid used for resuscitation, collect blood chloride values for the first 3 days.
Determine the proportion of patients with hyperchloremia and factors related to hyperchloremia in
patients with septic shock. Results: Study on 94 patients diagnosed with septic shock with median
age of 14.5 years, male rate was 56.4%, mortality rate was 25.5%. In which, the rate of hyperchloremia
in the first 3 days, in the first day, second day and the third day was 48.9%, 18.9%, 35.1% and 22.1%,
respectively. The volume of normal saline used for resuscitation on the first day of the hyperchloremic
group was higher than that of the non-hyperchloremic group (50.57 ml/kg and 23.66 ml/kg, p=0.006),
there was a positive correlation between the volume of normal saline used on the first day with blood
chloride levels on day 2 and day 3 with correlation coefficients of 0.409 and 0.246, respectively. The
group of patients with hyperchloremia had lower age than the group without hyperchloremia. History
of preterm birth is a factor that increases the risk of hyperchloremia with OR = 4.714 (1.221-18,201,
p= 0.016). By the logistic regresion analysis, independent risk factor with p-value < 0,05 was amounts
of normal saline on the first day and history of preterm birth. Conclusion: Hyperchloremia is common
in patients with septic shock after resuscitation. Infusion of large volume of normal saline on the first
day and history of preterm birthare factors that associated with hyperchloremia.