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[Metabolism and effects of phosphorus in eutrophic infants dehydrated from diarrhea]
Insights
Dehydrated infants with diarrhea may not be phosphate depleted. Phosphate administration did not show immediate retention, suggesting it may not be necessary for initial recovery from metabolic acidosis in this population.
Area of Science:
- Pediatrics
- Biochemistry
- Clinical Nutrition
Context:
- Infants with diarrhea and dehydration often experience metabolic acidosis.
- Phosphate depletion is a potential complication, but its prevalence and impact on recovery are not fully understood.
Purpose:
- To investigate phosphate depletion in dehydrated infants with diarrhea.
- To determine if phosphate administration influences the recovery from metabolic acidosis.
Summary:
- This study compared a control group receiving standard IV fluids and formula with a study group receiving additional sodium phosphate.
- Electrolyte balances and hydrogen ion excretion were monitored daily for 6 days.
- Phosphate administration did not demonstrate immediate retention and clinical outcomes were similar between groups, suggesting no immediate depletion or benefit.
Impact:
- Findings suggest that routine phosphate depletion may not occur in dehydrated infants with diarrhea.
- Phosphate administration may not be essential for the initial stages of metabolic acidosis recovery in this patient group.
- Highlights the complex interplay between phosphate, nitrogen, and calcium metabolism during rehydration.
Abstract:
To verify whether there is a state of phosphate depletion in dehydrated infants with diarrhea and whether phosphate administration affects recovery from metabolic acidosis, two groups of infants were studied. All were males, from 1 to 7 months old, and in good nutritional state. The control group was treated with a standard regimen of I.V. fluids initially, followed by feedings of a diluted milk formula starting on the 2nd day of treatment. The study group, in addition to this standard regimen, received sodium phosphate (Na2HPO4/Na2HPO4, 4:1, pH 7.4), initially by the I.V. route and thereafter orally with the feedings, at the dose of 2mM/kg/day. During the first 6 days of treatment, daily electrolyte (Na, K, Ca, Mg. Cl and P) and nitrogen balances were recorded. Hydrogen ion excretion (NH4 + TA--HCO3) was determined daily. Clinical findings and course were similar in the two groups. No untoward effects were observed with phosphate administration. In the control group, P balance was negative during all the periods and losses were in excess of those expected from nitrogen losses, thus suggesting a state of depletion. In the P-treated group however, P retention was not demonstrated in the first 2 days, finding a not suggestive of a P depleted state. Linear regressions between both daily and cumulative balances of P-nitrogen-free and Ca indicated a close correlation, thus suggesting that these two ions are mobilized concommitantly.