TO STUDY PH DISORDERS IN SEVERE ACUTE MALNUTRITION

OBJECTIVE: To study pH disorders in severe acute malnutrition.DESIGN: A prospective, cohort, observational study.SETTING: Severe malnutrition treatment unit in a tertiary level care hospital in central India.PARTICIPANTS: 202 children between 6 to 60 months of age.METHODOLOGY: Radial artery sample was taken at admission which was analyzed by automated blood gas analyzer; results were studied and correlated with nutritional status at discharge/outcome. STATISTICAL ANALYSIS:The data were analyzed using SPSS 20.Univariate and bivariate analysis of data was done using the Student t test and two-tailed Fisher exact or chi-square test.RESULTS: Out of 202 children studied 51.5% were males and 48.5% were females, 16.8% children had pH <7.35, 43.6% had pH between 7.35 to 7.45 and 39.6% had pH >7.45.The mean values of pH, HCO3 -, PCO2, PO2 and Cl -were 7.42, 17.1mmol/l, 25.22 mmHg, 93.71mmHg and 109.05mmol/lrespectively.Most children (n = 173/202; 85.6%) were discharged, 11(5.4 %) expired and 18 patients left the treatment.In pH < 7.35 group, mortality rate was highest (P value < 0.00001).Rate of weight gain in all groups were comparable and duration of stay was 16½ days in normal pH group and was 19 days in pH < 7.35 and 17 ½ days in pH > 7.46 group.CONCLUSION: In this study, metabolic acidosis with hyperchloremia was associated with poor outcome.There is no significant change in the duration of hospital stay and rate of weight gain in any pH group.