Postoperative hypophosphatemia: a multifactorial problem

This case study from the Boston Veterans Administration Medical Center emphasizes the signs, pathogenesis, and importance of hypophosphatemia in the setting of postoperative intensive nutritional support. Multiple contributing factors, including preoperative nutritional depletion, alcoholism, antacid therapy, and intracellular shifts induced by intravenous administration of glucose solutions were all involved in the pathogenesis of hypophosphatemia. Other risk factors are identified; familiarity with these should alert physicians to look for this potentially fatal but easily treatable, iatrogenic nutritional disorder.