Context: Malnourished children are at increased risk of many common infections and their complications. In those hospitalized with Severe Acute Malnutrition (SAM), concomitant infections and diarrhoea are frequent complications resulting in adverse outcome. Metabolic acidosis is a consequence of dehydration in diarrhoea, and the diagnosis of dehydration is based on history of fluid loss. Present study carried out to find the predictors of metabolic acidosis among children hospitalized with SAM.

Aims: To study the predictors of metabolic acidosis among children hospitalized
with severe acute malnutrition.

Settings and Design: Department of Paediatrics Shyam Shah Medical College Rewa, Prospective cross sectional study.

Methods and Material: Children between 6-60 months fulfilling the WHO criteria of SAM were enrolled. Variables recorded were sociodemograghic, anthropometry, history, clinical sign and laboratory results. Study population was grouped in children with (case) and without metabolic acidosis as (control). WHO guidelines for management of SAM was used to treat the morbidities.

Statistical analysis used: Data was analyzed by using SPSS 16, variables were initially analyzed in univariate model, and then independently associated factors with metabolic acidosis were identify using logistic regression analysis. A probability of less than 0.05 was considered statistically significant (p<0.05).

Results: Out of total 202 children, 91 (45%) children developed metabolic acidosis, 110 (54%) out of 202  children were presented with either acute watery diarrhoea or vomiting or both; out of which 69 (62%) developed metabolic acidosis and association of fluid loss was significant (p<0.001). Septic shock, watery diarrhoea and vomiting were independently associated with metabolic acidosis in SAM children.

Conclusions: History of fluid loss either in form of loose motion or loose motion with vomiting and septic shock were independently predict metabolic acidosis
in SAM children.

Keywords: Metabolic Acidosis; Severe Acute Malnutrition; Dehydration; Shock.