Biarent D, Brumagne C, Steppe M, Bouton J M
Free University of Brussels, Intensive Care Unit for Children, Hôpital Universitaire des Enfants, Reine Fabiola, Belgium.
JPEN J Parenter Enteral Nutr. 1992 Nov-Dec;16(6):558-60. doi: 10.1177/0148607192016006558.
After major surgery, seven infants aged 4 to 29 weeks, under parenteral nutrition, received monosodium phosphate (4.2 to 14.3 mEq/kg body weight) instead of prescribed calcium gluconate. The wrong solution was perfused during 16 hours. At the 15th hour, blood samples showed hyperphosphatemia in all (8.0 to 14.4 mg/100 mL) and hypocalcemia in four infants (6.1 to 8.0 mg/100 mL), but all were asymptomatic. Under a perfusion of glucose in water, calcemia and phosphatemia returned to normal within 24 hours. In a review of the pediatric literature, we found 11 subjects with symptomatic acute phosphate intoxication, who also presented with hypocalcemia and hyperphosphatemia. The differences were that they received high bolus doses of phosphate orally or rectally and showed symptomatic features. Normalization of the calcemia occurred only when hyperphosphatemia was corrected throughout intravenous hydration.
大手术后，7名年龄在4至29周的婴儿接受肠外营养时，输注的是磷酸二氢钠（4.2至14.3 mEq/千克体重）而非处方中的葡萄糖酸钙。错误的溶液持续输注了16小时。在第15小时，血液样本显示所有婴儿均出现高磷血症（8.0至14.4毫克/100毫升），4名婴儿出现低钙血症（6.1至8.0毫克/100毫升），但所有婴儿均无症状。在输注葡萄糖水溶液后，血钙和血磷在24小时内恢复正常。在回顾儿科文献时，我们发现11例有症状的急性磷酸盐中毒患者，他们也出现了低钙血症和高磷血症。不同之处在于，他们经口服或直肠接受了大剂量推注磷酸盐并表现出症状。只有在通过静脉补液纠正高磷血症后，血钙才恢复正常。
