Department of General Intensive Care, Beilinson Hospital, Rabin Medical Center, Petah Tikva 4941492, Israel.
Industrial Engineering and Management, Ariel University, Ari'el 4077625, Israel.
Nutrients. 2022 Mar 23;14(7):1332. doi: 10.3390/nu14071332.
Hypophosphatemia may prolong ventilation and induce weaning failure. Some studies have associated hypophosphatemia with increased mortality. Starting or restarting nutrition in a critically ill patient may be associated with refeeding syndrome and hypophosphatemia. The correlation between nutrition, mechanical ventilation, and hypophosphatemia has not yet been fully elucidated.
A retrospective cohort study of 825 admissions during two consecutive years was conducted. Using the electronic medical chart, demographic and clinical data were obtained. Hypophosphatemia was defined as a phosphate level below 2.5 mg/dL (0.81 mmol/L) in the first 72 h of ICU admission. Comparisons between baseline characteristics and outcomes and multivariate analysis were performed.
A total of 324 (39.27%) patients had hypophosphatemia during the first 72 h of ICU admission. Patients with hypophosphatemia tended to be younger, with lower APACHE-II, SOFA24, and ΔSOFA scores. They had a longer length of stay and length of ventilation, more prevalent prolonged ventilation, and decreased mortality. Their energy deficit was lower. There was no effect of hypophosphatemia severity on these results. In multivariate analysis, hypophosphatemia was not found to be statistically significant either with respect to mortality or survivor's length of ventilation, but lower average daily energy deficit and SOFA24 were found to be statistically significant with respect to survivor's length of ventilation.
Hypophosphatemia had no effect on mortality or length of ventilation. Lower average daily energy deficit is associated with a longer survivor's length of ventilation.
低磷血症可延长通气时间并导致撤机失败。一些研究表明低磷血症与死亡率增加有关。在危重病患者中开始或重新开始营养支持可能与再喂养综合征和低磷血症有关。营养、机械通气和低磷血症之间的相关性尚未完全阐明。
对连续两年的 825 例住院患者进行回顾性队列研究。通过电子病历获取人口统计学和临床数据。低磷血症定义为 ICU 入院前 72 小时内血磷水平低于 2.5mg/dL（0.81mmol/L）。比较基线特征和结局，并进行多变量分析。
共有 324 例（39.27%）患者在 ICU 入院前 72 小时内出现低磷血症。低磷血症患者倾向于更年轻，APACHE-II、SOFA24 和ΔSOFA 评分更低。他们的住院时间和通气时间更长，更常见的是通气时间延长，死亡率降低。他们的能量不足更低。低磷血症的严重程度对这些结果没有影响。多变量分析显示，低磷血症与死亡率或幸存者通气时间均无统计学意义，但平均每日能量不足和 SOFA24 与幸存者通气时间有统计学意义。
低磷血症对死亡率或通气时间没有影响。较低的平均每日能量不足与幸存者通气时间较长有关。
