Background: The authors reviewed some physiopathologic and clinical aspects about the prevention of hypophosphatemia during total parenteral nutrition (TPN) in patients undergoing abdominal surgery. Patients and Methods: We grouped 35 patients according to their nutritional regimen: 1st group (normonutrition): 20 with parenteral hypocaloric treatment (800 kcal/day) and phosphatic supply of 40 mEq/day; 2nd group (malnutrition): 15 treated with hypercaloric TPN (35 kcal/kg/day) and phosphatic supply of 40 mEq/day (7 of 15 = subgroup 2a) or a phosphatic supply of 60 mEq/day (remaining 8 of 15 = subgroup 2b). Results: The first group of patients had phosphatemia greater than 2.1 mg%mL; for subgoup 2a we obtained the following results: 4 presented phosphatemia greater than 1 mg%mL (during the first 4 days of treatment), 2 had phosphatemia ranging from 0.9 to 1 mg%mL, 1 had phosphatemia of 0.43 mg%mL during the second day; for subgroup 2b the results were: 7 with phosphatemia greater than 2.5 and 1 with phosphatemia of 2.3 mg%mL during the first day. Our study demonstrated a statistically significant difference in hypophosphatemia onset between subgroups 2a and 2b and another statistically significant difference between the first group of patients and subgroup 2a. Conclusions: Our experience suggests that during hypercaloric TPN combined with a lack of phosphatic supply, hypophosphatemia can be observed during the first days of treatment. A phosphatic supply of 60 mEq/day and proper patient monitoring during the first week is useful to prevent the problem in order to avoid a reduction of Daily Allowance of Caloric on Nutrients support.
|Titolo:||Preventing hypophosphatemia during total parenteral nutrition (TPN). Some pathophysiologic and clinical correlations|
|Autori interni:||CAGLIA', Pietro|
|Data di pubblicazione:||1999|
|Rivista:||RIVISTA ITALIANA DI NUTRIZIONE PARENTERALE ED ENTERALE|
|Appare nelle tipologie:||1.1 Articolo in rivista|