Refeeding hypophosphataemia after enteral nutrition in a Malaysian intensive care unit: risk factors and outcome

Background and Objectives: Refeeding hypophosphataemia (RH) is characterized by an acute electrolyte derangement following nutrition therapy. Complications associated include heart failure, respiratory failure, paraesthesia, seizure and death. We aim to assess its incidence, risk factors, and outcom...

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Main Authors:	Md Ralib, Azrina, Mat Nor, Mohd Basri
Format:	Article
Language:	English English English
Published:	Healthy Eating Club (HEC) Pty. Ltd. 2018
Subjects:	R Medicine (General)
Online Access:	http://irep.iium.edu.my/58151/ http://irep.iium.edu.my/58151/ http://irep.iium.edu.my/58151/ http://irep.iium.edu.my/58151/1/58151_Refeeding%20hypophosphataemia%20after%20enteral.pdf http://irep.iium.edu.my/58151/2/58151_Refeeding%20hypophosphataemia%20after%20enteral_WOS.pdf http://irep.iium.edu.my/58151/13/58151_Refeeding%20hypophosphataemia%20after%20enteral_SCOPUS.pdf

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recordtype	eprints
spelling	iium-581512018-10-29T02:47:59Z http://irep.iium.edu.my/58151/ Refeeding hypophosphataemia after enteral nutrition in a Malaysian intensive care unit: risk factors and outcome Md Ralib, Azrina Mat Nor, Mohd Basri R Medicine (General) Background and Objectives: Refeeding hypophosphataemia (RH) is characterized by an acute electrolyte derangement following nutrition therapy. Complications associated include heart failure, respiratory failure, paraesthesia, seizure and death. We aim to assess its incidence, risk factors, and outcome in our local intensive care unit (ICU). Methods and Study Designs: A prospective observational cohort study was conducted at the mixed medical-surgical of a tertiary ICU in Kuantan, Malaysia. The study was registered under the National Medical Research Register (NMRR-14-803-19813) and has received ethical approval. Inclusion criteria include adult admission longer than 48 hours who were started on enteral feeding. Chronic renal failure patients and those receiving dialysis were excluded. RH was defined as plasma phosphate less than 0.65 mmol/L and a drop of more than 0.16 mmol/L following feeding. Results: A total of 109 patients were recruited, of which 44 (42.6%) had RH. Patients with RH had higher SOFA score compared to those without (p=0.04). There were no differences in the APACHE II and NUTRIC scores. Serum albumin was lower in those with RH (p=0.04). After refeeding, patients with RH had lower serum phosphate, magnesium and albumin, and higher supplementation of phosphate, potassium and calcium. There were no differences in mortality, length of hospital or ICU stay. Conclusions: Refeeding hypophosphataemia occurs in almost half of ICU admission. Risk factors for refeeding include high organ failure score and low albumin. Refeeding was associated with imbalances in phosphate, magnesium, potassium and calcium. Future larger study may further investigate these risk factors and long-term outcomes. Healthy Eating Club (HEC) Pty. Ltd. 2018-02 Article PeerReviewed application/pdf en http://irep.iium.edu.my/58151/1/58151_Refeeding%20hypophosphataemia%20after%20enteral.pdf application/pdf en http://irep.iium.edu.my/58151/2/58151_Refeeding%20hypophosphataemia%20after%20enteral_WOS.pdf application/pdf en http://irep.iium.edu.my/58151/13/58151_Refeeding%20hypophosphataemia%20after%20enteral_SCOPUS.pdf Md Ralib, Azrina and Mat Nor, Mohd Basri (2018) Refeeding hypophosphataemia after enteral nutrition in a Malaysian intensive care unit: risk factors and outcome. Asia Pacific Journal of Clinical Nutrition, 27 (2). pp. 329-335. ISSN 0964-7058 http://apjcn.nhri.org.tw/server/APJCN/27/2/329.pdf 10.6133/apjcn.062017.09
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Md Ralib, Azrina Mat Nor, Mohd Basri Refeeding hypophosphataemia after enteral nutrition in a Malaysian intensive care unit: risk factors and outcome
description	Background and Objectives: Refeeding hypophosphataemia (RH) is characterized by an acute electrolyte derangement following nutrition therapy. Complications associated include heart failure, respiratory failure, paraesthesia, seizure and death. We aim to assess its incidence, risk factors, and outcome in our local intensive care unit (ICU). Methods and Study Designs: A prospective observational cohort study was conducted at the mixed medical-surgical of a tertiary ICU in Kuantan, Malaysia. The study was registered under the National Medical Research Register (NMRR-14-803-19813) and has received ethical approval. Inclusion criteria include adult admission longer than 48 hours who were started on enteral feeding. Chronic renal failure patients and those receiving dialysis were excluded. RH was defined as plasma phosphate less than 0.65 mmol/L and a drop of more than 0.16 mmol/L following feeding. Results: A total of 109 patients were recruited, of which 44 (42.6%) had RH. Patients with RH had higher SOFA score compared to those without (p=0.04). There were no differences in the APACHE II and NUTRIC scores. Serum albumin was lower in those with RH (p=0.04). After refeeding, patients with RH had lower serum phosphate, magnesium and albumin, and higher supplementation of phosphate, potassium and calcium. There were no differences in mortality, length of hospital or ICU stay. Conclusions: Refeeding hypophosphataemia occurs in almost half of ICU admission. Risk factors for refeeding include high organ failure score and low albumin. Refeeding was associated with imbalances in phosphate, magnesium, potassium and calcium. Future larger study may further investigate these risk factors and long-term outcomes.
format	Article
author	Md Ralib, Azrina Mat Nor, Mohd Basri
author_facet	Md Ralib, Azrina Mat Nor, Mohd Basri
author_sort	Md Ralib, Azrina
title	Refeeding hypophosphataemia after enteral nutrition in a Malaysian intensive care unit: risk factors and outcome
title_short	Refeeding hypophosphataemia after enteral nutrition in a Malaysian intensive care unit: risk factors and outcome
title_full	Refeeding hypophosphataemia after enteral nutrition in a Malaysian intensive care unit: risk factors and outcome
title_fullStr	Refeeding hypophosphataemia after enteral nutrition in a Malaysian intensive care unit: risk factors and outcome
title_full_unstemmed	Refeeding hypophosphataemia after enteral nutrition in a Malaysian intensive care unit: risk factors and outcome
title_sort	refeeding hypophosphataemia after enteral nutrition in a malaysian intensive care unit: risk factors and outcome
publisher	Healthy Eating Club (HEC) Pty. Ltd.
publishDate	2018
url	http://irep.iium.edu.my/58151/ http://irep.iium.edu.my/58151/ http://irep.iium.edu.my/58151/ http://irep.iium.edu.my/58151/1/58151_Refeeding%20hypophosphataemia%20after%20enteral.pdf http://irep.iium.edu.my/58151/2/58151_Refeeding%20hypophosphataemia%20after%20enteral_WOS.pdf http://irep.iium.edu.my/58151/13/58151_Refeeding%20hypophosphataemia%20after%20enteral_SCOPUS.pdf
first_indexed	2023-09-18T21:22:12Z
last_indexed	2023-09-18T21:22:12Z
_version_	1777411956489060352

Refeeding hypophosphataemia after enteral nutrition in a Malaysian intensive care unit: risk factors and outcome

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