[Perioperative hypophosphatemia in general surgery].

Area of Science:

• Clinical Biochemistry
• Surgical Nutrition
• Critical Care Medicine

Background:

• Hypophosphatemia is a common perioperative complication in general surgery patients.
• Understanding phosphorus metabolism is vital for managing surgical patients, particularly those with gastrointestinal issues.

Purpose of the Study:

• To investigate the incidence of perioperative hypophosphatemia in general surgery patients.
• To evaluate the effects of different phosphate supplementation regimens during intravenous feeding on blood phosphorus levels.

Main Methods:

• Measured blood phosphorus in 136 admitted general surgery patients.
• Conducted a randomized controlled trial with 16 patients undergoing digestive tract surgery, fasting post-operation.
• Administered varying daily doses of glucose and phosphate via transfusion over 7 days.

Main Results:

• 23.5% of patients exhibited hypophosphatemia during the perioperative period.
• Glucose-only infusions significantly decreased blood phosphorus levels.
• Phosphate supplementation (7.5-15 mmol/day) helped normalize blood phosphorus levels within 7 days, with higher doses showing moderate effects.

Conclusions:

• Perioperative hypophosphatemia is linked to poor absorption, intracellular phosphorus shifts, and urinary excretion.
• Recommended phosphate intake for prevention: 7-9 mmol/100 kcal daily.
• Recommended phosphate intake for treatment: 7-15 mmol/1000 kcal daily.