Hypophosphatemia

Revision as of 07:39, 18 December 2013 by Rossdonaldson1 (talk | contribs) (Treatment)

Background

  • 2.5-2.8 Mild
  • 1.0-2.5 Mod
  • <1.0 Severe

Diagnosis

Treatment

  1. Mild-mod
    1. KPhos /neutra phos PO
  2. Severe
    1. KPhos 2.5-5 mg/kg IV over 6hr

Harbor UCLA Adult Treatment Guidelines

  1. Serum phosphate 1 mg/dl to 2 mg/dl
    1. Able to take PO
      1. Minimize or eliminate all dextrose-containing IV solutions
      2. Aggressively treat acidosis
      3. 1 tab K-phos neutral 250mg Q hour x 5 doses
        1. Each tab contains phosphorus 8 mmol, Na 13 mEq, K1.1 mEq
      4. Recheck serum phosphate after last dose, and repeat dosing if continues to be <2 mg/dl
    2. NOT able to take PO
      1. Minimize or eliminate all dextrose-containing IV solutions
      2. Aggressively treat acidosis
      3. Give 15 mmol of IV potassium phosphate over 2.5 hours (contains 22 mEq K)
        1. Peripheral administration may cause burning at injection site
        2. Consider central venous administration, if available
        3. Repeat dosing regimen if serum phosphate remains <2 mg/dl
  2. Serum phosphate <1 mg/dl
    1. Minimize or eliminate all dextrose-containing IV solutions
      1. Exceptions: vasopressors, sedatives, analgesics, antibiotics, blood products, NS
    2. Aggressively treat acidosis
    3. Give 45 mmol of IV potassium phosphate over 7 hours (contains 66 mEq of K)
      1. Peripheral administration may cause burning at injection site
      2. Consider central venous administration, if available
    4. If patient can tolerat PO, ALSO follow steps 1 above
    5. Recheck serum phosphate after infusion
      1. Repeat IV administration if <1 mg/dl
      2. Consider oral administration if >1mg and <2 mg/dl