Investigation of Serum Electrolyte Imbalances in Neonates Undergoing Cardiac Surgery

Abstract

Background: Neonatal cardiac surgery is crucial for addressing congenital heart anomalies yet poses a risk of notable perioperative electrolyte disturbances. Imbalances resulting from blood loss, fluid shifts, and surgical effects can negatively impact patients, leading to issues such as acute kidney injury (AKI), arrhythmias, and elevated mortality rates. Objectives: The objective of this research is to assess the prevalence and outcomes of electrolyte imbalances during the perioperative, intraoperative, and postoperative phases on morbidity and mortality in neonates undergoing cardiac surgery. Methods: This study, conducted as a retrospective, single-center analysis, encompassed 355 neonatal patients who underwent cardiac surgery at a tertiary city hospital from January 2021 to January 2024. The study involved neonates under one month old diagnosed with congenital heart disease who underwent cardiac surgery within this timeframe. Electrolyte levels (sodium, potassium, calcium, chloride) were documented preoperatively, intraoperatively, and postoperatively, along with clinical outcomes such as AKI, arrhythmias, seizures, intensive care unit (ICU) length of stay, and mortality. Statistical analyses, both descriptive and inferential, were conducted to examine the connections between electrolyte imbalances and clinical outcomes, using logistic regression. Results: Notable correlations were identified between preoperative hyponatremia, hypocalcemia, hypochloremia, and the onset of AKI. The presence of arrhythmias was connected to preoperative hypocalcemia and postoperative hypernatremia and hyperchloremia. No significant relationship was found between any electrolyte imbalance and seizures. Mortality showed a significant association with preoperative hyponatremia, hypocalcemia, and hypochloremia, as well as postoperative hypernatremia and hyperchloremia. Conclusions: Perioperative electrolyte imbalances are commonly observed in neonates undergoing cardiac surgery and have a strong association with negative outcomes. Managing these imbalances proactively may result in a decrease in complications, notably AKI and arrhythmias, and an enhancement in survival rates.