Hypophosphatemia and its clinical implications in critically ill children: A retrospective study

Kılıç, Ömer; Demirkol, Demet; Üçsel, Raif; Çıtak, Agop; Karaböcüoğlu, Meti̇n

doi:10.1016/j.jcrc.2012.03.005

Cited by 29 publications

(60 citation statements)

References 27 publications

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“…18 Hy pophosphatemia may increase bone resorption in associa tion with bone metabolism in preterm infants. 9 In the present study, 20,21 In our study, the duration of invasive mechanical ventilation was not different between the two groups; however, the prevalence rate of BPD, duration of oxygen therapy, was higher in the hypophosphatemia group compared to that in the control group. Although the effect of hypophosphatemia on the respiratory system remains unclear, hypophosphatemia may cause or exacerbate respiratory failure by interfering with weaning from the mechanical ventilator and impairing the con tractility of the diaphragm.…”

Section: Discussioncontrasting

confidence: 37%

Late and Insufficient Phosphorus Supplementation is Associated with Early Severe Hypophosphatemia in Extremely Low Birth Weight Infants with Early Amino Acid Administration

et al. 2018

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Objective: To investigate the incidence of early severe hypophosphatemia, and examine the associated clinical factors and outcomes, in extremely low birth weight infants (ELBWI) who received early amino acid administration. Methods: Medical records of 82 ELBWI were retrospectively reviewed. Severe hypophosphatemia was defined as a serum phosphate level <2 mg/dL during the first week after birth. Results: Nineteen ELBWI (23.2%) experienced severe hypophosphatemia. The supplementation of phosphorus was started significantly later in the hypophosphatemia group compared to that in the control group (P=0.036). Small for gestational age infants (SGAI) (P=0.006) and bronchopulmonary dysplasia (P=0.016) were more prevalent in the hypophosphatemia group compared to that in the control group. Conclusion: Early severe hypophosphatemia is common in ELBWI. Late and insufficient supplemen tation of phosphorus and SGAI were associated with severe hypophosphatemia.

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Section: Discussioncontrasting

confidence: 37%

Late and Insufficient Phosphorus Supplementation is Associated with Early Severe Hypophosphatemia in Extremely Low Birth Weight Infants with Early Amino Acid Administration

et al. 2018

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“…16 De Menezes et al reported 76% of the critical children had hypophosphatemia on admission 6 & 60% in a retrospective Turkish study. 19 Meneses et al found that hypophosphatemia was common in the first 10 days of ICU hospitalization and was associated with the diagnosis of respiratory disease, use of dopamine, and malnutrition. 20 Also phosphorus in our study had shown a declining trend on day 3 and 10 of pediatric ICU admission; re feeding syndrome and tissue catch up after initial period of metabolic stress can explain this together with the fact that ICU doctors pay little attention to early phosphorus replacement.…”

Section: Discussionmentioning

confidence: 99%

Calcium, magnesium and phosphorus deficiency in critically ill children

Beleidy

Sherbini

El-Gebaly

et al. 2017

Egyptian Pediatric Association Gazette

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a b s t r a c tIntroduction: Critical illness may trigger an acute phase response which is associated with several metabolic derangements. These include hypo-and hypercalcemia, hypo-and hyperphosphatemia, hypo-and hypomagnesaemia. Method: Therefore, we conducted a prospective, non-interventional study in 10 beds intensive care unit of the at Pediatric Intensive Care Unit, Cairo University Pediatric Hospital. During 6 months period to investigate the incidence & risk factors of magnesium, phosphorus & calcium deficiency in patients admitted to the intensive care unit (ICU) on admission and followed the course of deficiency at day 3 & ten during stay. Results: Out of 70 patients, the frequency of Calcium deficiency was (34%), magnesium deficiency (31%), phosphorus deficiency (47%) on admission. Calcium and magnesium deficiency frequency changed gradually after 72 h & 10 days; in response to intravenous supplementation for deficient patients. While phosphorus level declined during follow up. Respiratory failure (87%) was the most common organ failure followed by neurological failure. Patients with hypocalcaemia on admission had a higher PELOD score (P = 0.10), coagulopathy (P = 0.044), sepsis diagnoses (P = 0.007), metabolic acidosis (P = <0.001), hyperglycemia (P = 0.006) hypomagnesaemia (P = <0.001), hypoalbuminemia (P = 0.004). While hypomagnesaemia risk factors were coagulopathy (P = 0.039), inborn error of metabolism (P = 0.039), sepsis diagnoses (P = 0.045), hypocalcaemia (P = <0.001), hypophosphatemia (P = 0.004), hypoalbuminemia (P = 0.042). Hypophosphatemia was associated with hypokalemia (P = 0.003) & hypomagnesaemia (P = 0.004). Regression analysis revealed metabolic acidosis & hyperglycemia were associated with calcium deficiency, while inborn error of metabolism and hypophosphatemia with magnesium deficiency. Risk factors for Hypophosphatemia are hypokalemia & hypomagnesaemia. Conclusion: Hypophosphatemia was the most frequent and under estimated electrolyte disturbance in our study. Ó 2017 The Egyptian Pediatric Association. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). IntroductionDisorders of magnesium, calcium and phosphorus are common in patients admitted to intensive care units. 1 Routine monitoring and replacement of these ions are still underemphasized. 2 Most studies focus, on individual electrolytes without taking the interrelationship between specific deficits into account. Hypocalcaemia is a common derangement in both medical and surgical patients requiring intensive care. The reported prevalence varies significantly between studies due to differences in the population studied and the cutoff values used, with published figures ranging from 15% to 88%. 3 Magnesium is the fourth most common cation in the body and second most common intracellular cation after potassium, yet its deficiency is frequently overlooked. Various studies have reported the incidence of hypomagnesemia up to 65% in ...

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“…Hypophosphatemia is responsible for various clinical consequences, such as cardiac, respiratory, neuromuscular, and hematological disorders, which are closely associated with morbidity and potential mortality [5]. Previously, respiratory failure has been depicted in severely hypophosphatemic patients, attributed to ventilatory dysfunction [3][4][5]. Phosphate is an essential component of adenosine tri-phosphate (ATP).…”

mentioning

confidence: 99%

“…Phosphate is an essential component of adenosine tri-phosphate (ATP). In case of severe hypophosphatemia, decreased levels of ATP for respiratory muscle contraction may be responsible for the onset of acute respiratory insufficiency [3][4][5]. In emergency services, respiratory failure is a frequent medical problem, however, hypophosphatemia associated respiratory failure is an infrequent condition and may easily be under-diagnosed.…”

mentioning

confidence: 99%

Dyspnea and Generalized Paresthesias Due to a Rare Metabolic Disorder: Severe Hypophosphatemia

Uslu¹,

Tanoğlu²,

Sait³

et al. 2016

Med-Science

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Hypophosphatemia and its clinical implications in critically ill children: A retrospective study

Cited by 29 publications

References 27 publications

Late and Insufficient Phosphorus Supplementation is Associated with Early Severe Hypophosphatemia in Extremely Low Birth Weight Infants with Early Amino Acid Administration

Late and Insufficient Phosphorus Supplementation is Associated with Early Severe Hypophosphatemia in Extremely Low Birth Weight Infants with Early Amino Acid Administration

Calcium, magnesium and phosphorus deficiency in critically ill children

Dyspnea and Generalized Paresthesias Due to a Rare Metabolic Disorder: Severe Hypophosphatemia

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