Abstract
Objective
To determine the incidence of hypophosphatemia in a surgical intensive care unit and to determine whether or not a phosphorus challenge causes a change in cardiac performance in hypophosphatemic patients.
Design
Prospective clinical study and case reports.
Setting
Surgical intensive care unit in an universitu hospital.
Patients
A total of 208 consecutive patients admitted to the surgical ICU were evaluated over a 6 months period.
Interventions
All classical risk factors for hypophosphatemia were recorded. A group of 8 moderate or severe hypophosphatemic patients were evaluated for hemodynamic data before and after a phosphorus load. Glucose phosphate was given over 30 min by the intravenous route. Dosage regimen was 0.4 mmol/kg weight for moderate hypophosphatemia and 0.8 mmol/kg weight for severe hypophosphatemia.
Results
Risk factors were present in 134 patients and 60 patients were hypophosphatemic (44.8%). Only 3 risk factors were discriminant for hypophosphatemia: sepsis, diuretics and total parenteral nutrition. The mortality was higher in the hypophosphatemic group than in the normophosphatemic group (30% versus 15.2%;p<0.05). Cardiac performance improved after phosphatemia normalization in all patients (cardiac index: 3.82±1.87 versus 4.52±1.83 l/min·m2;p<0.01).
Conclusion
This study underlines the high incidence (28.8%) of hypophosphatemia in surgical intensive care patients and its association with a high mortality rate (30%). A short course of phosphotherapy improves cardiac index (+18%).
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Zazzo, J.F., Troché, G., Ruel, P. et al. High incidence of hypophosphatemia in surgical intensive care patients: Efficacy of phosphorus therapy on myocardial function. Intensive Care Med 21, 826–831 (1995). https://doi.org/10.1007/BF01700966
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DOI: https://doi.org/10.1007/BF01700966