Document Detail


Intravenous phosphate in the intensive care unit: more aggressive repletion regimens for moderate and severe hypophosphatemia.
MedLine Citation:
PMID:  12845429     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate efficacy and safety of aggressive correction of hypophosphatemia with intravenous potassium phosphate in the ICU. DESIGN AND SETTING: Randomized interventional prospective study in the medical and surgical ICU of a tertiary university hospital. PATIENTS: Critically ill patients with hypophosphatemia between June and November 1998. MEASUREMENTS AND RESULTS: Patients with moderate hypophosphatemia (<0.65 and >0.40 mmol/l; n=37) were randomized into two groups: group 1 received 30 mmol potassium phosphate intravenously in 50 ml saline over 2 h, and group 2 received 30 mmol potassium phosphate in 100 ml saline over 4 h. Patients with severe hypophosphatemia (<0.40 mmol/l; n=10) were also randomized into two groups: group 3 received 45 mmol potassium phosphate intravenously in 100 ml saline over 3 h, and group 4 received 45 mmol potassium phosphate in 100 ml saline over 6 h. Electrolytes, blood gas, renal function were monitored until day 3; urine was collected during and until 6 h after infusions. The overall efficacy of the protocols was 98% by the end of the infusion. There was no statistical difference in phosphate values between groups at the end of infusion or at 24 h. No adverse events were noted; one patient had an increase in serum potassium to 6.1 mmol/l. Phosphaturia in all groups was elevated as evidenced by fractional excretion above 20%. CONCLUSIONS: More rapid administration of large potassium phosphate boluses is effective and safe for correcting hypophosphatemia in ICU patients with preserved renal function if baseline serum potassium is below 4 mmol/l.
Authors:
Thierry Charron; Francis Bernard; Yoanna Skrobik; Nathalie Simoneau; Nadine Gagnon; Martine Leblanc
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial     Date:  2003-07-05
Journal Detail:
Title:  Intensive care medicine     Volume:  29     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-07     Completed Date:  2005-04-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1273-8     Citation Subset:  IM    
Affiliation:
Medical and Surgical Intensive Care Units, Maisonneuve-Rosemont Hospital, University of Montreal, 5415 de l'Assomption, H1T 2M4, Montreal, PQ, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Humans
Hypophosphatemia / drug therapy*,  physiopathology
Infusion Pumps
Intensive Care Units
Male
Middle Aged
Phosphates / administration & dosage,  therapeutic use*
Potassium Compounds / administration & dosage,  therapeutic use*
Prospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Phosphates; 0/Potassium Compounds; 16068-46-5/potassium phosphate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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