Electrolyte And Acid Base Disturbances In Patients With Severe Closed Traumatic Brain Injury

Aim: The aim of this study was to evaluate the alteration of serum electrolytes and arterial blood gases as a secondary insult in patients with severe closed traumatic brain injury and to estimate its impact on patients' outcome. Materials and Methods: 80 patients with severe closed traumatic brain injury were admitted to neurosurgical intensive care unit between November 2013 and November 2014. All patients were treated conservatively without surgical intervention. Data collected include demographic characteristics, daily ABG, and serum electrolytes for the first 5 days, as well as patients, outcome. Results: Of the 80 patients, 71 (88.8%) were male and 9 (11.2%) were female with mean age of 27.45±16.46 year. Road traffic accident was the commonest cause of head injury in 65% of patients, and 18.8% of patients had traumatic brain injury only while the remaining 81.2% of the patients had associated systemic or spine injury. On day one, 71. 3% of the patients had abnormal pH with acidosis more commonly encountered in 37.5% of patients. 72.5% had abnormal serum Na+, with hyponatremia in 41.3% of the patients. Abnormal serum K+ was reported in 55% of patients with hypokalemia in 37.5%. Bad outcome was reported in 73.75%. Abnormal pH, serum electrolytes were significantly associated with bad outcome in all 5 readings reported for pH, serum Na+ and K+. Conclusion: The results of this study showed that in patients with severe closed traumatic brain injury abnormal pH and serum Na+ and K+ are common events and are significantly associated with bad outcome