Severe electrolyte disturbances are common and potentially life-threatening conditions in critically ill patients, requiring immediate ICU management. Electrolytes such as sodium, potassium, calcium, magnesium, and phosphate play a vital role in cellular function, nerve conduction, muscle contraction, and cardiac rhythm. Significant imbalances can rapidly lead to arrhythmias, seizures, respiratory failure, and circulatory collapse.

Electrolyte disturbances may arise from kidney failure, endocrine disorders, severe infections, gastrointestinal losses, medications, or prolonged critical illness. Patients may present with confusion, muscle weakness, abnormal heart rhythms, seizures, or sudden cardiovascular instability. In the ICU, continuous monitoring allows early detection before catastrophic complications occur.

Management in the ICU focuses on identifying the underlying cause and correcting electrolyte abnormalities in a controlled and safe manner. Rapid correction can be dangerous, particularly for sodium disorders, and must be carefully titrated under close supervision. Cardiac monitoring is essential when managing potassium and calcium abnormalities due to the high risk of arrhythmias.

Critically ill patients often have multiple electrolyte abnormalities simultaneously, complicating management. ICU teams use frequent laboratory testing and individualized treatment protocols to maintain electrolyte balance while addressing associated organ dysfunction.

Severe electrolyte disturbances are often markers of underlying critical illness severity. Prompt ICU intervention not only corrects the imbalance but also prevents secondary organ damage and improves overall outcomes.