Prevalence of hypophosphatemia in the ICU – Results of an international one-day point prevalence survey. Issue 5 (May 2021)

• Record Type: Journal Article
• Authors: Berger, M.M.; Appelberg, O.; Reintam-Blaser, A.; Ichai, C.; Joannes-Boyau, O.; Casaer, M.; Schaller, S.J.; Gunst, J.; Starkopf, J.; Abel, Arroyo; Erna, Alberts; Berger Mette, M.; Guillaume, Besch; Costel, Besançon Bodolea; Michael, Casaer; Pérez, Cheng Meisy; Jean-Michel, Constantin; Swarna, Deepak; de Man Angelique, M.E.; Frantisek, Duska; Patricia, Fodor; Kristina, Fuest; Thierry, Fumeaux; Hubert, Grand; Gundogan, K.; Jan, Gunst; Mohan, Gurjar; Laurent, Heyer; Shihan, Huq; Carole, Ichai; Motiul, Islam; Samir, Jaber; Nikilesh, Jain; Matthieu, Jamme; Ib, Jammer; Olivier, Joannes-Boyau; Veronika, Jung; Inga, Karu; Kamal Habeeb, Keryakos Hesham; Gian-Reto, Kleger; Tim, Krol; Friedrich, Kuhn Karl; Marcus, Laube; Yoann, Launey; Manu, Malbrain; Manrique Ezequiel, ; Julien, Marrel; Roberto, Martinez-Alejos; Mongardon, Nicolas; Conway, Morris Andrew; Madhu, Pahuja; Fernando, Pereira; Gema, Pérez; Marie-Helene, Perez; Carmen, Pfortmuller; Annika, Reintam Blaser; Ricardo, Rosenfeld; Noryani, Samat; Schaller Stefan, J.; Shannon, Simpson; Kelly, Straka; Tamas, Szakmany; Kadri, Tamme; Arthur, Van Zanten; Verçoza, Viana Marina;
• Is Part Of: Clinical nutrition. Volume 40:Issue 5(2021)
• Page Start: 3615
• Page End: 3621
• Publication Date: 2021-05
• Subjects: Critically ill -- Electrolyte -- Nutrition -- Repletion -- Standard operating procedure -- Monitoring; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2020.12.017
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background & aims: Hypophosphatemia (HypoP) is associated with organ dysfunction and mortality. Despite its potential severe consequences, HypoP remains poorly characterized in terms of real prevalence and timing of onset. The primary objective was to determine the prevalence of HypoP defined as blood phosphate <0.8 and < 0.65 mmol/l on one particular day at international level. Methods: One-day point prevalence survey conducted by the Section of Metabolism, Endocrinology and Nutrition (MEN) of the European Society of Intensive Care Medicine (ESICM) during week 11–2020. Results: In total, 56 adult and 4 paediatric ICUs, from 22 countries participated: 41 ICUs were mixed medico surgical, the 19 others being cardiac, medical or surgical. Phosphate measurements were performed daily in 21 ICUs, and 1–3 times per week in 39 ICUs. On D-Day 909 patients (883 adults) were present and 668/883 (75.7%) had serum/plasma phosphate determined, revealing a HypoP in 103 (15.4%) patients aged 62 [18 to 85] years. Of those, 49 patients presented phosphate <0.65 mmol/l: cases of hypophosphatemia were detected at any time of patient's ICU stay. No HypoP was observed in children. A treatment protocol existed only in 41.1% of adult ICUs, independently of ICU type, or size. Only 41/98 of the HypoP patients (29/41 of patients with phosphate <0.65 mmol/l) were receiving phosphate. Conclusion: HypoP is present at least in 15.4% of ICU patients, and may occur at any time during the ICU stay. The absence of phosphate repletion protocols in 60% of participating ICUs is an unexpected finding, and confirms the necessity for the development of ICU phosphate protocols and guidelines. ClinicalTrials identifier: NCT04201899