Received: 8 January 2003
Accepted: 23 May 2003
Published online: 5 July 2003
© Springer-Verlag 2003
Abstract Objective: To evaluate ef-
ficacy and safety of aggressive cor-
rection of hypophosphatemia with
intravenous potassium phosphate in
the ICU. Design and setting: Ran-
domized interventional prospective
study in the medical and surgical
ICU of a tertiary university hospital.
Patients: Critically ill patients with
hypophosphatemia between June and
November 1998. Measurements and
results: Patients with moderate hy-
pophosphatemia (<0.65 and
>0.40 mmol/l; n=37) were random-
ized into two groups: group 1 re-
ceived 30 mmol potassium phos-
phate intravenously in 50 ml saline
over 2 h, and group 2 received
30 mmol potassium phosphate in
100 ml saline over 4 h. Patients with
severe hypophosphatemia
(<0.40 mmol/l; n=10) were also ran-
domized into two groups: group 3 re-
ceived 45 mmol potassium phos-
phate intravenously in 100 ml saline
over 3 h, and group 4 received
45 mmol potassium phosphate in
100 ml saline over 6 h. Electrolytes,
blood gas, renal function were moni-
tored until day 3; urine was collected
during and until 6 h after infusions.
The overall efficacy of the protocols
was 98% by the end of the infusion.
There was no statistical difference in
phosphate values between groups at
the end of infusion or at 24 h. No ad-
verse events were noted; one patient
had an increase in serum potassium
to 6.1 mmol/l. Phosphaturia in all
groups was elevated as evidenced by
fractional excretion above 20%.
Conclusions: More rapid administra-
tion of large potassium phosphate
boluses is effective and safe for cor-
recting hypophosphatemia in ICU
patients with preserved renal func-
tion if baseline serum potassium is
below 4 mmol/l.
Keywords Phosphorus · Infusion ·
Critical illness · Phosphaturia ·
Treatment
Intensive Care Med (2003) 29:1273–1278
DOI 10.1007/s00134-003-1872-2
ORIGINAL
Thierry Charron
Francis Bernard
Yoanna Skrobik
Nathalie Simoneau
Nadine Gagnon
Martine Leblanc
Intravenous phosphate in the intensive care