Hypophosphatemia Occurs Early in Intensive Care Unit (ICU) Stay and Is Associated with Increased Duration of Mechanical Ventilation and ICU and Hospital Stay.

Doig, GS; Bellomo, Rinaldo; Simpson, F. O.; Hegarty, Colin; Egi, Moritoki; Sweetman, EA; Heighes, Philippa T.

doi:10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a3809

Cited by 2 publications

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“…showed that 50% of hypophosphatemia occurred early during ICU stay and explained that, it may be associated with re-feeding syndrome. In these patients, reducing caloric intake should be considered[ 12 ] although Grewal et al . reported that underfeeding does not appear to protect against hypophosphatemia, and other ICU interventions may predispose to hypophosphatemia.…”

Section: Discussionmentioning

confidence: 99%

“…reported that underfeeding does not appear to protect against hypophosphatemia, and other ICU interventions may predispose to hypophosphatemia. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

“…This study showed the relationship between severities of hypophosphatemia with duration of ICU stay and MV, but hospital stay days and mortality rate were not significantly different. [ 12 ]…”

Section: Introductionmentioning

confidence: 99%

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The Predicting Ability of Serum Phosphorus to Assess the Duration of Mechanical Ventilation in Critically Ill Patients

et al. 2017

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Background:No previous study exists to evaluate serum phosphorus (Ph) level as a predictor of the need to mechanical ventilation (MV). This study was designed to determine the predictive ability of admission serum Ph level on MV in patients admitted in Intensive Care Unit (ICU).Materials and Methods:This prospective study was conducted on 100 patients (>16 years old), admitted to our ICU over 1-year. Patients were classified into two groups according to the days of the need to MV. Group A: Patients who required equal or <5 days MV, and Group B: Patients who required more than 5 days of MV. We measured total serum Ph concentrations at the times of ICU admission, connecting to the ventilator and weaning from the ventilator.Results:There were significant differences between serum Ph concentration on admission to ICU (Group A: 3.39 ± 0.39 mg/dl, Group B: 2.89 ± 0.31 mg/dl, P < 0.001), at the time of connecting to ventilator (Group A: 2.49 ± 0.38 mg/dl, Group B: 2.25 ± 0.26 mg/dl, P = 0.004) and weaning from ventilator (Group A: 3.42 ± 0.33 mg/dl, Group B: 2.98 ± 0.34 mg/dl, P < 0.001) between two groups. Duration of ICU stay in Group A was 6.08 ± 1.48 days and in Group B was 15.35 ± 6.45, this difference was significant (P < 0.001). We found the best cut-off point of 3.07 for serum Ph concentration to predict the longer duration of MV.Conclusion:According to the results of our study, hypophosphatemia may increase the need to MV. Therefore, monitoring serum Ph level is a good prognostic factor to predict the need to ventilation.

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Section: Discussionmentioning

confidence: 99%

“…reported that underfeeding does not appear to protect against hypophosphatemia, and other ICU interventions may predispose to hypophosphatemia. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

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The Predicting Ability of Serum Phosphorus to Assess the Duration of Mechanical Ventilation in Critically Ill Patients

et al. 2017

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“…Brunelli and Goldfarb reported that 28-33% of patients admitted to the ICU were found to have hypophosphatemia [17]. According to Doig et al, hypophosphatemia was observed in 37% of the 2,915 patients evaluated throughout their ICU stay; of these, 50% of instances occurred within the first eight days of ICU admission [18]. In our study, patients with hypophosphatemia at baseline were corrected accordingly.…”

Section: Discussionmentioning

confidence: 50%

Hypophosphatemia in Chronic Obstructive Pulmonary Disease Patients Requiring Mechanical Ventilation and Its Impact on Weaning in an Intensive Care Unit of a Tertiary Care Hospital in Eastern India

Kundu,

Ahmed,

Prasad

2024

Cureus

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BackgroundHypophosphatemia, defined as a serum phosphate level less than 2.5 mg/dL, is a frequent finding in patients with chronic obstructive pulmonary disease (COPD) and has been speculated to negatively affect weaning outcomes. This study aimed to determine the incidence of hypophosphatemia in COPD patients requiring mechanical ventilation and evaluate the predictive role of hypophosphatemia as an indicator of successful weaning from mechanical ventilation in such patients admitted to the intensive care unit (ICU) in a tertiary care hospital in eastern India. MethodologyThis prospective observational study included 60 adult patients aged 18 to 75 years with acute exacerbations of COPD on mechanical ventilation in the ICU who were planned to undergo a weaning trial. Serum phosphate levels were assessed at the time of admission and before each weaning attempt. Weaning outcomes at each attempt, length of ventilator and ICU stay, and mortality were recorded. Data collection was initiated after approval of the Institutional Ethics Committee. Receiver operating curve (ROC) analysis was done to identify the cut-off value of serum phosphate which predicted successful weaning. ResultsOf 60 participants, hypophosphatemia on admission was present in 15 (25%) patients. Despite the correction, 13 (21.7%) patients had hypophosphatemia before the first weaning attempt. Only 22 patients out of 60 were successfully weaned off from mechanical ventilation in the first trial, accounting for a success rate of 36.7%, of whom 20 were normophosphatemic (90.9%). In the second and third weaning trials, hypophosphatemia was significantly associated with weaning failure. Overall differences in mean serum phosphate levels among those who failed to wean in each weaning trial and the successful attempt were statistically significant (p < 0.001). On ROC analysis of serum phosphate level before the first weaning trial, a cut-off value of ≥3.0 mg/dL was identified to have 86.4% sensitivity, 55.3% specificity, 52.8% positive predictive value, 87.5% negative predictive value, and 66.7% diagnostic accuracy in predicting weaning success. Five patients died, accounting for a mortality rate of 8.3%. Lower mean serum phosphate levels before the first weaning trial, higher mean age, and longer ventilator and ICU days were significantly associated with mortality among our study participants (p < 0.05). ConclusionsOur findings suggest that maintaining normal serum phosphate levels is critical to successfully weaning off patients with COPD from ventilator support.

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Hypophosphatemia Occurs Early in Intensive Care Unit (ICU) Stay and Is Associated with Increased Duration of Mechanical Ventilation and ICU and Hospital Stay.

Cited by 2 publications

References 0 publications

The Predicting Ability of Serum Phosphorus to Assess the Duration of Mechanical Ventilation in Critically Ill Patients

The Predicting Ability of Serum Phosphorus to Assess the Duration of Mechanical Ventilation in Critically Ill Patients

Hypophosphatemia in Chronic Obstructive Pulmonary Disease Patients Requiring Mechanical Ventilation and Its Impact on Weaning in an Intensive Care Unit of a Tertiary Care Hospital in Eastern India

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