• Kübra Çeleğen and Mehmet Çeleğen.
• MD. Physician, Pediatric Nephrologist in Division of Pediatric Nephrology, Department of Pediatrics, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey.
• Sao Paulo Med J. 2024 Jan 1; 142 (4): e2022370e2022370.

BackgroundHyperchloremia is often encountered due to the frequent administration of intravenous fluids in critically ill patients with conditions such as shock or hypotension in the pediatric intensive care unit, and high serum levels of chloride are associated with poor clinical outcomes.ObjectivesThis study aimed to determine the association between hyperchloremia and in-hospital mortality in pediatric patients with major trauma.Design And SettingThis retrospective cohort study was conducted at a tertiary university hospital in Turkey.MethodsData were collected between March 2020 and April 2022. Patients aged 1 month to 18 years with major trauma who received intravenous fluids with a concentration > 0.9% sodium chloride were enrolled. Hyperchloremia was defined as a serum chloride level > 110 mmol/L. Clinical and laboratory data were compared between the survivors and nonsurvivors.ResultsThe mortality rate was 23% (n = 20). The incidence of hyperchloremia was significantly higher in nonsurvivors than in survivors (P = 0.05). In multivariate logistic analysis, hyperchloremia at 48 h was found to be an independent risk factor for mortality in pediatric patients with major trauma.ConclusionsIn pediatric patients with major trauma, hyperchloremia at 48-h postadmission was associated with 28-day mortality. This parameter might be a beneficial prognostic indicator.

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