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This study investigates the anomalies in glucose, sodium, calcium, potassium, and acid\u2013base homeostasis induced by binge drinking in adolescents. The records of teenagers who sought medical attention for binge drinking (ethanol level\u2009\u2265\u20090.80\u00a0g\/L) at the Pediatric Emergency Department, Ca\u2019 Granda Ospedale Maggiore Policlinico, Milan (Italy), spanning the years 2013 to 2023 were retrospectively analyzed. For this analysis, cases were selected if documented blood chemistry encompassed sodium, potassium, total calcium, glucose, acid\u2013base balance, and lactic acid (only for those with metabolic acidosis). Included were 173 adolescents (female-to-male ratio 0.94), 13.2 to 18.4, median 16.4\u00a0years of age. Hypoglycemia (\u2264\u20093.3\u00a0mmol\/L;\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u20091, 0.6%), hyponatremia (\u2264\u2009134\u00a0mmol\/L;\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u20097, 4.0%), hypernatremia (\u2265\u2009146\u00a0mmol\/L;\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u20093, 1.7%), hypocalcemia (\u2264\u20092.19\u00a0mmol\/L;\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u20090) hypercalcemia (\u2265\u20092.61\u00a0mmol\/L;\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u20090), and hyperkalemia (\u2265\u20095.1\u00a0mmol\/L;\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u20090) were infrequent. Acute respiratory acidosis (pCO\n                    <jats:sub>2<\/jats:sub>\n                    \u2009\u2265\u200946\u00a0mm Hg; pH\u2009&lt;\u20097.40;\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u2009101, 58%) was the most common acid\u2013base imbalance, followed by respiratory alkalosis (pCO\n                    <jats:sub>2<\/jats:sub>\n                    \u2009\u2264\u200934\u00a0mm Hg; pH\u2009&gt;\u20097.40;\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u200910, 5.6%), and metabolic acidosis (HCO\n                    <jats:sub>3<\/jats:sub>\n                    <jats:sup>-<\/jats:sup>\n                    \u2009\u2264\u200919\u00a0mmol\/L, pH\u2009&lt;\u20097.40;\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u20099, 5.2%). The lactic acid level was increased (\u2265\u20092.1\u00a0mmol\/L) in all\u00a0cases with metabolic acidosis. Metabolic alkalosis (HCO\n                    <jats:sub>3<\/jats:sub>\n                    <jats:sup>-<\/jats:sup>\n                    \u2009\u2265\u200928\u00a0mmol\/L, pH\u2009&gt;\u20097.40) never occurred. Hypokalemia (\u2264\u20093.4\u00a0mmol\/L;\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u200956, 32%) was prevalent, particularly in adolescents with normal acid\u2013base equilibrium or metabolic acidosis, rather than respiratory acidosis or alkalosis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion<\/jats:italic>\n                    : Adolescents who engage in binge drinking often experience a disrupted acid\u2013base balance and hypokalemia, while glucose, sodium and calcium levels are rarely affected.\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td align=\"left\">\n                              <jats:bold>What is known?<\/jats:bold>\n                              \u2022\n                              <jats:italic>Binge drinking is becoming increasingly common among adolescents.<\/jats:italic>\n                              \u2022\n                              <jats:italic>Conflicting data regarding the type and prevalence of biochemical disorders induced by binge drinking are available in this age group.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td align=\"left\">\n                              <jats:bold>What is new?<\/jats:bold>\n                              \u2022\n                              <jats:italic>Acute respiratory acidosis is prevalent in adolescents with binge drinking, whereas respiratory alkalosis, metabolic acidosis, and hypoglycemia are uncommon.<\/jats:italic>\n                              \u2022\n                              <jats:italic>Hypokalemia\u00a0develops frequently.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-024-05862-3","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:11:14Z","timestamp":1733962274000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of adolescents\u2019 binge drinking on blood chemistry"],"prefix":"10.1007","volume":"184","author":[{"given":"Enrico","family":"Pistritto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica M. 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UE 679\/2016 and D.Lgs 196\/2003 (Codice della Privacy) as reported by D.Lgs 101\/2018).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The data supporting the findings of this study can be obtained from the corresponding authors upon appropriate request.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data Access Statement"}},{"value":"Generative artificial intelligence was used to improve readability and language of the manuscript.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Generative Artificial Intelligence"}},{"value":"Gregorio P Milani is currently one of the Editors of the European Journal of Pediatrics.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"77"}}