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资源有限国家非手术重症患者低磷血症治疗的替代方法

An Alternative Approach to Treatment of Hypophosphatemia in Nonsurgical Critically Ill Patients in Countries With Limited Resources.

作者信息

Kovačević Tijana, Kovačević Peđja, Tomić Boris, Dragić Saša, Momčičević Danica

机构信息

Clinical Pharmacy, University Clinical Centre of the Republic of Srpska, Banja Luka, Republic of Srpska, Bosnia and Herzegovina.

School of medicine, University of Banjaluka, Banja Luka, Bosnia and Herzegovina.

出版信息

Dose Response. 2019 May 23;17(2):1559325819850421. doi: 10.1177/1559325819850421. eCollection 2019 Apr-Jun.

Abstract

BACKGROUND

Hypophosphatemia can complicate and prolong the treatment of critically ill patients, and it is even thought to be related to mortality rate.

OBJECTIVES

The aim of this study is to determine whether using extemporary prepared phosphate buffer in pharmacy would help correct serum phosphate in critically ill patients.

METHODS

A prospective study was conducted at the medical intensive care unit over a period of 1 year and included 50 patients who were diagnosed with hypophosphatemia. Phosphate buffer was prepared at the pharmacy, and the dose range was recommended by a clinical pharmacist.

RESULTS

Patients were administered phosphate buffer via the nasogastric tube, and the doses chosen by the physicians depended on serum phosphate level and the severity of the patients' clinical status. Serum phosphate levels were successfully corrected in all treated patients. The most frequently used dose was 60 mmoL/d, and in most patients 1-day therapy was sufficient. No adverse effects were observed.

CONCLUSION

The phosphate buffer is an adequate alternative for the treatment of hypophosphatemia of nonsurgically critically ill patients. One-day therapy with the 60 mmoL phosphate dose divided into 3 single doses resulted in normalization of serum phosphate values in most patients.

摘要

背景

低磷血症会使重症患者的治疗复杂化并延长治疗时间,甚至被认为与死亡率有关。

目的

本研究旨在确定在药房临时配制磷酸盐缓冲液是否有助于纠正重症患者的血清磷水平。

方法

在医疗重症监护病房进行了为期1年的前瞻性研究,纳入50例诊断为低磷血症的患者。磷酸盐缓冲液在药房配制,剂量范围由临床药师推荐。

结果

通过鼻胃管给患者使用磷酸盐缓冲液,医生选择的剂量取决于血清磷水平和患者临床状况的严重程度。所有接受治疗的患者血清磷水平均成功得到纠正。最常用的剂量是60 mmol/d,大多数患者1天的治疗就足够了。未观察到不良反应。

结论

磷酸盐缓冲液是治疗非手术重症患者低磷血症的一种合适替代方法。将60 mmol磷酸盐剂量分为3次单剂量进行1天治疗,可使大多数患者的血清磷值恢复正常。

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本文引用的文献

4
Hypophosphataemia. Pathophysiology, effects and management on the intensive care unit.
Anaesthesia. 1998 Sep;53(9):895-902. doi: 10.1046/j.1365-2044.1998.00463.x.
8
Treatment of severe hypophosphatemia.严重低磷血症的治疗。
Ann Intern Med. 1978 Dec;89(6):941-4. doi: 10.7326/0003-4819-89-6-941.

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