Hypophosphatemia in hypercatabolic patients.

Twenty-four hypercatabolic surgical intensive care patients were treated with a daily phosphate dosage of 0.5 mmol/kg b.wt during the postoperative total parenteral nutrition (TPN). The adequacy of this regimen was evaluated by measuring the plasma phosphate concentration before and after five days of TPN. All the patients were in negative nitrogen balance throughout the study. Ten of them were hypophosphatemic at the beginning, while none was hypophosphatemic at the end of the study. Hyperphosphatemia was observed once, at the end of the study. The catabolic surgical patient receiving parenteral nutrition is at risk of hypophosphatemia, and particularly vulnerable to its consequences. A daily dosage of 0.5 mmol/kg b.wt of phosphate appeared adequate in covering the increased requirements of these patients.