Discloremia as a Clinical Predictor in Neurocritical Patients: A Retrospective Observational Study in the Intensive Care Unit at Hospital Manolo Morales Peralta, Nicaragua

Introduction: Discloremia, encompassing hypochloremia and hyperchloremia, is a frequent complication in critically ill patients receiving chloride-rich solutions. This study explores the associations between discloremia, osmotic solution use, and clinical outcomes in neurocritical patients. Methods: A descriptive, correlational, and analytical study was conducted at Manolo Morales Peralta Hospital. We evaluated 75 patients with neurocritical pathologies, analyzing their demographics, clinical characteristics, osmotic therapy use, discloremia development, and clinical outcomes. Results: The study population predominantly comprised males (62.67%) with a mean age of 61 years. Ischemic cerebrovascular events were the most frequent diagnosis (38.67%). Notably, 65.52% of patients received 3% saline solution. Discloremia development was associated with chloride levels at 48 hours (p = 0.009). Serum chloride levels above 114 mEq/L correlated with prolonged ICU/hospital stay (p = 0.007). However, no significant associations were observed between discloremia and mortality or Rankin scale scores (p = 0.75). Discussion: Our findings suggest a complex relationship between discloremia and clinical outcomes in neurocritical patients. Future studies should explore tailored chloride management strategies to optimize clinical outcomes in this patient population.