Hypophosphatemia in the Intensive Care Unit: Incidence, Predictors and Management

Introduction: Our objectives are to identify the incidence of hypophosphatemia and the associated risk factors. We also want to establish intravenous replacement therapy that is effective for ICU patients. Methods: A prospective observational study assessing adults admitted to ICU in between March...

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Main Authors:	Mat Nor, Mohd Basri, Janattul, AJ, Md Ralib, Azrina, Abdul Hadi, M
Format:	Article
Language:	English
Published:	The Faculty of Medicine, International Islamic University Malaysia 2012
Subjects:	R Medicine (General)
Online Access:	http://irep.iium.edu.my/29082/ http://irep.iium.edu.my/29082/ http://irep.iium.edu.my/29082/1/Hypophosphatemia_in_the_Intensive_Care_Unit.pdf

id	iium-29082
recordtype	eprints
spelling	iium-290822017-04-06T08:19:22Z http://irep.iium.edu.my/29082/ Hypophosphatemia in the Intensive Care Unit: Incidence, Predictors and Management Mat Nor, Mohd Basri Janattul, AJ Md Ralib, Azrina Abdul Hadi, M R Medicine (General) Introduction: Our objectives are to identify the incidence of hypophosphatemia and the associated risk factors. We also want to establish intravenous replacement therapy that is effective for ICU patients. Methods: A prospective observational study assessing adults admitted to ICU in between March and May 2009. All patients without baseline phosphate level and renal failure were excluded. They were evaluated for the occurrence of common risk factors. Association with independent variables that includes age, gender and BMI were verified. Evaluation of IV replacement therapy was done in the treated patients. Results: From 50 patients that were reviewed, nine were excluded. There were 66% male and 34% female with mean age 46.88±17.89. The mean ICU stay was 8.00±6.41 days. The incidence of hypophosphatemia was 29% (n=12/41). Gender and creatinine clearance was found to be significantly different between normophosphatemia and hypophosphatemia patients. There was no significant association for each potential risk factor and the number of risk factors (≥3) with the incidence of hypophosphatemia. Multi-linear regression analysis showed that lactate, creatinine clearance and pH were significant predictors to the serum levels. A significant difference of mean serum phosphate was seen after repletion by total dose of 10, 20 and 40 mmols in the treatment subgroups. Conclusions: The incidence of hypophosphatemia in our ICU was high and comparable to previous studies. None of the commonly reported risk factors is associated with hypophosphatemia in this studied population. Among all significant correlated variables, only pH was found to be a significant predictor for serum phosphate. Baseline phosphate level may guide the initial replacement dose to prevent delay in normalization of serum levels. The Faculty of Medicine, International Islamic University Malaysia 2012 Article PeerReviewed application/pdf en http://irep.iium.edu.my/29082/1/Hypophosphatemia_in_the_Intensive_Care_Unit.pdf Mat Nor, Mohd Basri and Janattul, AJ and Md Ralib, Azrina and Abdul Hadi, M (2012) Hypophosphatemia in the Intensive Care Unit: Incidence, Predictors and Management. The International Medical Journal Malaysia, 11 (1). pp. 31-36. ISSN 1823-4631 http://iiumedic.net/imjm/v1/download/Volume%2011%20No%201/IMJM%20Vol11No1-2012-p31-36%28ed%29.pdf
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Mat Nor, Mohd Basri Janattul, AJ Md Ralib, Azrina Abdul Hadi, M Hypophosphatemia in the Intensive Care Unit: Incidence, Predictors and Management
description	Introduction: Our objectives are to identify the incidence of hypophosphatemia and the associated risk factors. We also want to establish intravenous replacement therapy that is effective for ICU patients. Methods: A prospective observational study assessing adults admitted to ICU in between March and May 2009. All patients without baseline phosphate level and renal failure were excluded. They were evaluated for the occurrence of common risk factors. Association with independent variables that includes age, gender and BMI were verified. Evaluation of IV replacement therapy was done in the treated patients. Results: From 50 patients that were reviewed, nine were excluded. There were 66% male and 34% female with mean age 46.88±17.89. The mean ICU stay was 8.00±6.41 days. The incidence of hypophosphatemia was 29% (n=12/41). Gender and creatinine clearance was found to be significantly different between normophosphatemia and hypophosphatemia patients. There was no significant association for each potential risk factor and the number of risk factors (≥3) with the incidence of hypophosphatemia. Multi-linear regression analysis showed that lactate, creatinine clearance and pH were significant predictors to the serum levels. A significant difference of mean serum phosphate was seen after repletion by total dose of 10, 20 and 40 mmols in the treatment subgroups. Conclusions: The incidence of hypophosphatemia in our ICU was high and comparable to previous studies. None of the commonly reported risk factors is associated with hypophosphatemia in this studied population. Among all significant correlated variables, only pH was found to be a significant predictor for serum phosphate. Baseline phosphate level may guide the initial replacement dose to prevent delay in normalization of serum levels.
format	Article
author	Mat Nor, Mohd Basri Janattul, AJ Md Ralib, Azrina Abdul Hadi, M
author_facet	Mat Nor, Mohd Basri Janattul, AJ Md Ralib, Azrina Abdul Hadi, M
author_sort	Mat Nor, Mohd Basri
title	Hypophosphatemia in the Intensive Care Unit: Incidence, Predictors and Management
title_short	Hypophosphatemia in the Intensive Care Unit: Incidence, Predictors and Management
title_full	Hypophosphatemia in the Intensive Care Unit: Incidence, Predictors and Management
title_fullStr	Hypophosphatemia in the Intensive Care Unit: Incidence, Predictors and Management
title_full_unstemmed	Hypophosphatemia in the Intensive Care Unit: Incidence, Predictors and Management
title_sort	hypophosphatemia in the intensive care unit: incidence, predictors and management
publisher	The Faculty of Medicine, International Islamic University Malaysia
publishDate	2012
url	http://irep.iium.edu.my/29082/ http://irep.iium.edu.my/29082/ http://irep.iium.edu.my/29082/1/Hypophosphatemia_in_the_Intensive_Care_Unit.pdf
first_indexed	2023-09-18T20:42:41Z
last_indexed	2023-09-18T20:42:41Z
_version_	1777409470579605504

Hypophosphatemia in the Intensive Care Unit: Incidence, Predictors and Management

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