Fluids, electrolytes, and acid-base status of critically ill patients on nutritional support at a University Hospital, Cairo

Background Fluids, electrolytes, and acid-base imbalance can adversely affect the survival and recovery of critically ill patients especially those on nutritional support. Therefore, early recognition and treatment are necessary and represent a fundamental nursing intervention. Aim To assess fluids, electrolytes, and acid-base status of critically ill patients on nutritional support at a University Hospital, Cairo - Egypt. Research questions 1-What is the status of fluids, electrolytes and acid-base among critically ill patients on nutritional support? and 2-What is the relationship between fluids, electrolytes and acid-base status and different nutritional support administered to critically ill patients? Research design A descriptive exploratory research design was used. Setting This study was carried out at different Intensive Care Units affiliated to Cairo University Hospitals. Sample A purposive sample consisting of 70 patients was included. Tools of data collection 1-Critically ill patients’ personal background and medical data form; 2-Fluids, electrolytes and acid-base status assessment form for critically ill patients on nutritional support and; 3-Critically Ill patients nutritional support assessment form. Results Hypovolemia was found among 50% of the studied sample, while hypervolemia was found among more than one-third (37%). In different assessment times the studied sample had abnormal levels of serum sodium in percentages of 24.3, 34.3, and 40%, respectively; serum potassium in percentages of 24.3, 54.3, and 47.1%, respectively; and serum calcium in percentages of 21.4, 32.9, and 20%, respectively; serum magnesium in percentages of 8.6, 22.9, and 11.4%, respectively, and serum phosphorus in percentages of 5.7, 12.9, and 5.7%, respectively. Metabolic acidosis and respiratory alkalosis were found among 24.3 and 35.7%, respectively. However, no significant statistical relationship was found between the modality of nutritional support, fluids, electrolytes, and acid-base status. Conclusion Critically ill patients receiving different nutritional support therapies are targeted for alterations in fluids, electrolytes, and acid-base that could negatively affect their recovery and outcomes. Recommendations Regular monitoring, prevention, and correction of fluids, electrolytes, and acid-base abnormalities among critically ill patients receiving nutritional support; Availability of illustrated guidelines about care of critically ill patients receiving nutritional support; and replication of this study on a larger probability sample selected from different geographical areas in Egypt.