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Hypophosphatemia in critically ill children.

Fernanda Souza de Menezes1, Heitor Pons Leite, Juliana Fernandez

  • 1Discipline of Nutrition and Metabolism and the Pediatric Intensive Care Unit, Department of Pediatrics, Federal University of São Paulo - São Paulo/SP, Brazil.

Revista Do Hospital Das Clinicas
|November 16, 2004
PubMed
Summary

Hypophosphatemia is common in critically ill children, affecting over 50% of patients. Early identification of this condition is vital for effective treatment and preventing complications.

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Area of Science:

  • Pediatric Intensive Care Medicine
  • Clinical Nutrition
  • Critical Care Nephrology

Background:

  • Hypophosphatemia is a significant electrolyte disturbance in critically ill patients.
  • Understanding its prevalence and risk factors in pediatric intensive care units (PICU) is essential for patient management.
  • Previous reviews have not specifically focused on the pediatric population in PICU settings.

Purpose of the Study:

  • To review clinical studies on hypophosphatemia in pediatric intensive care unit patients.
  • To determine the prevalence of hypophosphatemia in this population.
  • To identify associated risk factors for hypophosphatemia in critically ill children.

Main Methods:

  • Systematic literature search of Medline, Embase, Cochrane Library, and LILACS databases.

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  • Inclusion criteria focused on clinical trials and studies published between January 1990 and January 2004.
  • Exclusion criteria included specific conditions like prematurity, genetic syndromes, and renal diseases.

    • Main Results:

    • The prevalence of hypophosphatemia in critically ill pediatric patients exceeded 50%.
    • Commonly associated factors included refeeding syndrome, malnutrition, sepsis, trauma, and diuretic/steroid therapy.
    • Limited high-quality studies (one clinical trial, one retrospective study) were identified, with most being case reports.

    Conclusions:

    • Hypophosphatemia is highly prevalent in critically ill children.
    • Refeeding syndrome, malnutrition, sepsis, trauma, and certain therapies are key associated risk factors.
    • Early detection and management of hypophosphatemia are crucial to prevent complications in pediatric intensive care settings.