Hypophosphatemia and acute postoperative respiratory distress

In conclusion, the possibility of prolonged mechanical ventilation in patients with hypophosphatemia can be anticipated. Neuromuscular function should be monitored carefully when NMBAs are given as muscular dysfunction can arise even with apparent complete reversal. The cause of the respiratory failure (in this case, hypophosphatemia) must be sought and corrected while the patient's respiratory function is supported. Slow phosphorus replacement (10-45 mmol over 6-8 hours) must take place to avoid the complications of rapid infusion which are hypocalcemia and formation of calcium phosphate calcifications. Patients with electrolyte disorders are known to be a challenge for an anesthesiologist because of vital system involvements. Urgent surgery in a patient with hypophosphatemia should alert the anesthesiologist to the possibility of multiorgan failure and perhaps the need for postoperative mechanical ventilation.