Evidence map›Paper›PMID 36755633›Full record

ArticleIndian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine2022

Acute Diarrhea and Severe Dehydration in Children: Does Non-anion-gap Component of Severe Metabolic Acidemia Need More Attention?

Lalit Takia, Arun Kumar Baranwal, Pramod Kumar Gupta, Suresh Kumar Angurana, Muralidharan Jayashree

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PubMed Full text at PMC Publisher
In one paragraph

Article in Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Article
  6. Normal Anion Gap: A Knowledge Gap.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023
    Article
  7. Normal Anion Gap Metabolic Acidosis in Pediatric Acute Diarrhea: A Menace or an Innocent Bystander?Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Lalit TakiaDepartment of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.ORCID https://orcid.org/0000-0002-3027-7006
Arun Kumar BaranwalDepartment of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.ORCID https://orcid.org/0000-0003-4334-2652
Pramod Kumar GuptaDepartment of Biostatistics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.ORCID https://orcid.org/0000-0002-6767-3520
Suresh Kumar AnguranaDepartment of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.ORCID https://orcid.org/0000-0001-6370-8258
Muralidharan JayashreeDepartment of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.ORCID https://orcid.org/0000-0002-6149-1355
Post Graduate Institute of Medical Education and Research · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Despite significant loss of bicarbonate during acute diarrhea, pediatric data are scarce with acute diarrhea/severe dehydration (ADSD) and severe non-anion-gap metabolic acidemia (sNAGMA). We planned to study their clinical profile, critical care needs, and outcome. Patients: Children (1 month-12 years) with ADSD and sNAGMA (pH <7.2 and/or bicarbonate <15 mEq/L, and normal/mixed anion gap) admitted in Pediatric Emergency Department from January 2016 to December 2018 were enrolled. Children with pure high-anion-gap metabolic acidemia were excluded. Methods: Medical records were reviewed retrospectively. The primary outcome was time taken to resolve acidemia. Secondary outcomes were acute care area free days in 5 days (ACAFD Results: Out of 929 diarrhea patients admitted for intravenous therapy, 121 (13%; median age, 4 months) had ADSD and sNAGMA. Median (IQR) pH was 7.11 (7.01-7.22); 21% patients had pH <7.00. Hyperchloremia (96%) and hypernatremia (45%) were common. About 12% patients each required inotropes and ventilation, while 58% had acute kidney injury (AKI). Median (IQR) time for resolution of acidemia among survivors was 24 (12, 24) hours. Thirty-two patients had adverse outcome. Higher grades of sNAGMA were associated with shock, AKI, coma, hypernatremia, hyperkalemia, adverse outcome, and lesser ACAFD Conclusion: Severe non-anion-gap metabolic acidemia in children with ADSD is associated with organ dysfunctions, dyselectrolytemias, and lesser ACAFD5. Resolution of acidemia took unacceptably longer time. Higher grades of sNAGMA were a predictor of adverse outcomes. Trials are suggested to assess the role of additional bicarbonate therapy. How to cite this article: Takia L, Baranwal AK, Gupta PK, Angurana SK, Jayashree M. Acute Diarrhea and Severe Dehydration in Children: Does Non-anion-gap Component of Severe Metabolic Acidemia Need More Attention? Indian J Crit Care Med 2022;26(12):1300-1307.

Indexed as

Acute diarrheaAlkali therapyBicarbonateMetabolic acidemiaNon-anion-gap metabolic acidemiaSevere dehydration

Identifiers

PMID36755633
PMCPMC9886013
OpenAlexW4311430907

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.