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Hypophosphatemia in postoperative patients with total parenteral nutrition: influence of nutritional support teams
M J Martínez1, M A Martínez, M Montero
1Pharmacy Department, Meixoeiro Hospital, Vigo, Pontevedra, Spain.
Unlabelled:
PURPOSE, SETTING AND SUBJECTS: We conducted a prospective, descriptive study of postoperative patients under total parenteral nutrition controlled by a Multidisciplinary Nutritional Support Team in a tertiary care hospital. Between january 2002 and november 2003. Data of nutritional status, nutritional support, hypophosphatemia, electrolyte and metabolic complications were reviewed.
Results:
215 postoperative patients (63.3% male, 68 +/- 13.9 years old, 47.4% neoplasia). were included. Nutritional support according nutritional needs was made during fasting 14.2 +/- 18.4 days. Mild-moderate initial malnutrition was present in 58% of patients. 18.1% developed postoperative hypophosphatemia 96 hours after starting total parenteral nutrition containing phosphate. 37.7% patients showed moderated and 6.5% severe hypophosphatemia. Nutritional intervention corrected hypophosphatemia (p < 0.001). Factors related to hypophosphatemia were hypokalemia, hypomagnesemia, hypercalcemia, female sex, neoplasia, 96-hour postoperative period and duration of nutrition.
Conclusions:
Prevalence of hypophosphatemia in postoperative patients with total parenteral nutrition is high and needs timely monitoring. The intervention of Multidisciplinary Nutritional Support Team is effective detecting and correcting postoperative hypophosphatemia.
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