Modern Care Journal
Wed, Feb 25, 2026
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Volume 22, Issue 4 (10-2025)
Mod Care J 2025, 22(4): 0-0 |
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Lima Júnior W, Cerqueira Calderaro D, Passos R, Côrte M, Adalberto Leal J, Oliveira Mayrink M et al . Towards Safer Phosphate Repletion: A 24-Hour Weight-Based Infusion Protocol for Hypophosphatemic ICU Patients. Mod Care J 2025; 22 (4) : 7
URL: http://mcj.bums.ac.ir/article-1-346-en.html
URL: http://mcj.bums.ac.ir/article-1-346-en.html
Washington Lima Júnior1 
, Debora Cerqueira Calderaro *2 , Rogerio Passos3 , Margaret Côrte4 , José Adalberto Leal5 , Marcelo Oliveira Mayrink6 , Gilda Aparecida Ferreira7
, Debora Cerqueira Calderaro *2 , Rogerio Passos3 , Margaret Côrte4 , José Adalberto Leal5 , Marcelo Oliveira Mayrink6 , Gilda Aparecida Ferreira7
1- Nutrition and Diet Service, Governor Israel Pinheiro Hospital, Minas Gerais State Employee Pension Institute, Belo Horizonte, Minas Gerais, Brazil & Intensive Care Unit, São Rafael Hospital, Salvador, Bahia, Brazil
2- Department of Locomotor System, Falculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil. Email: dccalderaro@gmail.com
3- Intensive Care Unit, São Rafael Hospital, Salvador, Bahia, Brazil
4- Spech Therapy Nucleus, Governor Israel Pinheiro Hospital , Minas Gerais State Employee Pension Institute, Belo Horizonte, Minas Gerais, Brazil
5- Nutrition and Diet Service, Governor Israel Pinheiro Hospital, Minas Gerais State Employee Pension Institute, Belo Horizonte, Minas Gerais, Brazil
6- Hospital Brasília, Brasília, Brazil
7- Department of Locomotor System, Falculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazi
2- Department of Locomotor System, Falculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil. Email: dccalderaro@gmail.com
3- Intensive Care Unit, São Rafael Hospital, Salvador, Bahia, Brazil
4- Spech Therapy Nucleus, Governor Israel Pinheiro Hospital , Minas Gerais State Employee Pension Institute, Belo Horizonte, Minas Gerais, Brazil
5- Nutrition and Diet Service, Governor Israel Pinheiro Hospital, Minas Gerais State Employee Pension Institute, Belo Horizonte, Minas Gerais, Brazil
6- Hospital Brasília, Brasília, Brazil
7- Department of Locomotor System, Falculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazi
Abstract: (11 Views)
Background: Evidence on the safety and efficacy of phosphate (P) replacement in hypophosphatemic intensive care unit (ICU) patients remains limited. Objectives: To evaluate the efficacy and safety of a 24-hour weight-based intravenous phosphate replacement protocol. Methods: Adult ICU patients with hypophosphatemia received potassium acid phosphate (25 mL) diluted in 500 mL of saline or 5% glucose, administered via infusion pump. Dosing was 0.3 mmol/kg/24 h for mild hypophosphatemia (0.65 - 0.73 mmol/L) and 0.6 mmol/kg/24 h for moderate to severe cases (≤ 0.64 mmol/L). Phosphate levels were measured every 24 hours. Efficacy was defined as normalization of phosphate within 24 hours. Safety outcomes included hypocalcemia, hypotension, hyperphosphatemia, hyperkalemia, and acute kidney injury. Results: Among 134 patients (aged 67.6 ± 14.6 years; 55% female; median APACHE II median 18), 197 hypophosphatemia episodes were treated. Phosphate normalized within 24 hours in 121 episodes (61%). Mild adverse events occurred in 28 patients (21%); no severe complications were reported. Conclusions: This protocol is not a replacement for standard guidelines in symptomatic hypophosphatemia and unstable patients. It proved effective and generally safe in critically ill patients with mild to severe hypophosphatemia, offering a feasible approach in resource-limited ICU settings where oral formulations are unavailable and frequent laboratory monitoring is unfeasible.
Article number: 7
Article Types: Brief Report |
Subject:
General
Received: 2026/01/10 | Accepted: 2025/10/15 | Published: 2025/10/15
Received: 2026/01/10 | Accepted: 2025/10/15 | Published: 2025/10/15
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