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2023, Number 3

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Med Crit 2023; 37 (3)

Sodium (Na+)-chlorine (Cl-) difference and chlorine/sodium index (Cl-/Na+) as prognostic markers of mortality in patients with septic shock

Abasolo CBA, Mendoza RM, Cortés MJA, López GA

Language: Spanish
References: 34
Page: 186-194
PDF size: 266.63 Kb.


ABSTRACT

Introduction: sepsis and septic shock are the main conditions that most demand the services of the Intensive Care Unit (ICU), due to their high risk of mortality (10-40%). Septic shock is the most acute condition, since it affects circulation and cellular metabolism. In Mexico, a high prevalence is estimated, negatively affecting health indicators. In this sense, acid-base balance disorders are common in the ICU, with hyperchloremia being the most common triggering factor for metabolic acidosis in patients with septic shock, causing hypoperfusion and tissue hypoxia with endothelial damage. Objective: to demonstrate that the sodium (Na+)-chlorine (Cl-) difference and the chlorine/sodium ratio (Cl-/Na+) are associated with higher mortality in patients diagnosed with septic shock in the Intensive Care Unit of the Hospital General La Villa. Hypothesis: the relationship between the sodium chloride difference and the chloride/sodium ratio in patients with septic shock is associated with higher mortality in patients with septic shock. Material and methods: descriptive statistics were used (measures of central tendency and dispersion, as well as frequencies and percentages). Likewise, inferential statistics were used with the Student's t test, Mann-Whitney U test and χ2 with a confidence interval of 95%. Results: the total number of patients evaluated was 60, of which 25 (41.7%) corresponded to women. The age was 50.30 ± 7.91 years. 32 patients (53.3%) had diabetes mellitus. The variations at admission and after 24 hours were (Cl-) 1.54%, (Na+) 1.71%, (Na+)-(Cl-) 2.17% and (Cl-)/(Na+) -1.35%. The association of mortality with (Cl-) at admission (p = 0.805) and at 24 hours (p = 0.127); (Na+) at admission (p = 0.414) and at 24 hours (p = 0.282); (Na+)-(Cl-) at admission (p = 0.524) and at 24 hours (p = 0.082); (Cl-)/(Na+) at admission (p = 0.635) and at 24 hours (p = 0.209) was not statistically significant. Conclusion: the sodium chloride difference and the chloride/sodium ratio were not associated with higher mortality in patients with septic shock.


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