A New Graduated Dosing Regimen for Phosphorus Replacement in Patients Receiving Nutrition Support

Background: Hypophosphatemia is a common metabolic complication in patients receiving specialized nutrition support. We changed our previously reported dosing algorithm because the low dose no longer appeared to be effective at increasing serum phosphorus concentrations. The purpose of this study wa...

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Bibliographic Details
Published in:JPEN. Journal of parenteral and enteral nutrition 2006-05, Vol.30 (3), p.209-214
Main Authors: Brown, Kaleb A., Dickerson, Roland N., Morgan, Laurie M., Alexander, Kathryn H., Minard, Gayle, Brown, Rex O.
Format: Article
Language:English
Subjects:
Adult
Algorithms
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
APACHE
Biological and medical sciences
Clinical death. Palliative care. Organ gift and preservation
Critical Illness - therapy
Dose-Response Relationship, Drug
Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care
Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition
Enteral Nutrition
Female
Humans
Hypophosphatemia - prevention & control
Hypophosphatemia - therapy
Intensive care medicine
Male
Medical sciences
Nutritional Requirements
Nutritional Support
Parenteral Nutrition
Phosphates - administration & dosage
Phosphates - blood
Phosphorus - administration & dosage
Phosphorus - blood
Potassium Compounds - administration & dosage
Potassium Compounds - blood
Retrospective Studies
Safety
Treatment Outcome
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Summary:Background: Hypophosphatemia is a common metabolic complication in patients receiving specialized nutrition support. We changed our previously reported dosing algorithm because the low dose no longer appeared to be effective at increasing serum phosphorus concentrations. The purpose of this study was to evaluate the safety and efficacy of a revised weight-based phosphorus-dosing algorithm in critically ill trauma patients receiving specialized nutrition support. Methods: Seventy-nine adult trauma patients with hypophosphatemia (serum phosphorus concentration ≤0.96 mmol/L) receiving nutrition support received an IV dose of phosphorus on day 1 according to the serum concentration of phosphorus: 0.73–0.96 mmol/L (0.32 mmol/kg, low dose), 0.51–0.72 mmol/L (0.64 mmol/kg, moderate dose), and ≤0.5 mmol/L (1 mmol/kg, high dose). The IV phosphorus bolus dose was administered at 7.5 mmol/hour. Generally, patients with a serum potassium concentration
ISSN:0148-6071
1941-2444
DOI:10.1177/0148607106030003209