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Hypophosphatemia in Children Hospitalized Within an Intensive Care Unit

Pediatric Intensive Care Unit, Hospital São Paulo, Discipline of Nutrition and Metabolism, Department of Pediatrics, Federal University of São Paulo/Escola Paulista de Medicina, São Paulo, Brazil

Heitor Pons Leite, MD, PhD

Pediatric Intensive Care Unit, Hospital São Paulo, Discipline of Nutrition and Metabolism, Department of Pediatrics, Federal University of São Paulo/Escola Paulista de Medicina, São Paulo, Brazil, heitorpl{at}terra.com.br

Juliana Fernandez

Pediatric Intensive Care Unit, Hospital São Paulo, Discipline of Nutrition and Metabolism, Department of Pediatrics, Federal University of São Paulo/Escola Paulista de Medicina, São Paulo, Brazil

Silvana Gomes Benzecry, MD, MSc

Department of Pediatrics, University of Amazonas, São Paulo, Brazil

Werther Brunow de Carvalho, MD, PhD

Pediatric Intensive Care Unit, Hospital São Paulo, São Paulo, Brazil

The aims of this study were to estimate the occurrence of hypophosphatemia and to identify potential risk factors and outcome measures associated with this disturbance in children admitted to a pediatric intensive care unit. Data concerning 42 children admitted consecutively to 1 pediatric intensive care unit over a 1-year period were examined. Serum phosphorus levels were measured on the third day of admission, where levels below 3.8 mg/dL were considered indicative of hypophosphatemia. Hypophosphatemia was found in 32 children (76%), and there was a significant association between this disturbance and malnutrition (P = .04). Of the potential risk factors such as sepsis, diuretic/steroid therapy, starvation (over 3 days), and Pediatric Index of Mortality, none discriminated for hypophosphatemia. There were no associations between hypophosphatemia and mortality, length of stay in the pediatric intensive care unit, or time on mechanical lung ventilation. Hypophosphatemia was a common finding in critically ill children and was associated with malnutrition.

Key Words: phosphorus • children • malnutrition • critically ill

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