Heames R M, Cope R A
Shackleton Department of Anaesthesia, Southampton Hospitals NHS Trust, Southampton, UK.
Anaesthesia. 2006 Dec;61(12):1211-3. doi: 10.1111/j.1365-2044.2006.04839.x.
We report the case of a patient who developed severe cardiac failure after cardiac surgery and required high-dose inotrope infusion. The patient was found to have significant hypophosphataemia and high insulin requirements immediately after surgery. On giving intravenous phosphate, there was a rapid decrease in inotrope requirement and improved glycaemic control. This occurrence raises questions about the cause of hypophosphataemia after cardiac surgery, the possible need for pre-operative plasma phosphate measurement and whether phosphate replacement should be part of the standard management of postoperative hypophosphataemia.
我们报告了一例心脏手术后发生严重心力衰竭并需要大剂量输注正性肌力药物的患者。该患者术后立即被发现存在明显的低磷血症且胰岛素需求量高。给予静脉补充磷酸盐后，正性肌力药物的需求量迅速下降，血糖控制得到改善。这种情况引发了关于心脏手术后低磷血症的原因、术前血浆磷酸盐测量的必要性以及磷酸盐替代是否应成为术后低磷血症标准治疗一部分的问题。
