Evaluation of Serum Electrolytes in Traumatic Brain Injury Patients: Prospective Randomized Observational Study

Background: Traumatic brain injuries (TBI) are the major public health problem and devastating condition, with significant mortality and morbidity. Electrolyte imbalance after resuscitation in TBI patients are common and further aggravate this condition. The main objectives are prevention and treatment of intracranial hypertension and secondary brain insults, preservation of cerebral perfusion pressure (CPP), and optimization of cerebral oxygenation. Proper in time detection followed by appropriate management not only improves neurological status but also decrease morbidity and mortality. Aim: We evaluate the electrolyte derangement in traumatic brain injury patients 24 hour after resuscitation. Method: After Institutional Ethical approval and written informed consent, all TBI patients meeting inclusion criteria were included in this prospective observational study. Serum electrolytes (serum sodium, potassium, calcium and phosphate) were measured at time of admission and 24 hour after resuscitation. All patients received standard treatment according to institutional protocol for TBI patients. Result: Hypernatremia (27.30%) is the most common electrolyte abnormality followed by hyponatremia (18.73%), Hypokalemia (21.58%), Hyperkalemia (17.77%), hypocalcaemia (11.4%), Hyperphosphatemia (9.8%) followed hypophosphatemia (4.8%) within the first 24 hours after resuscitation. Conclusion: Electrolyte imbalance following traumatic head injury is an important cause to look for in patient monitoring. Sodium is the chief electrolytes of concern. Serum potassium, calcium and Phosphate levels also under goes notable changes. Based on CT scan findings several traumatic brain injuries associated with various electrolytes derangements are of important concern especially with in first 24 hours after resuscitation.