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Background
- 2.5-2.8 Mild
- 1.0-2.5 Mod
- <1.0 Severe
Diagnosis
- CNS
- Cardiac
- Impaired myocardial function
Treatment
- Mild-mod
- KPhos /neutra phos PO
- Severe
- KPhos 2.5-5 mg/kg IV over 6hr
Harbor UCLA Adult Treatment Guidelines
- Serum phosphate 1 mg/dl to 2 mg/dl
- Able to take PO
- Minimize or eliminate all dextrose-containing IV solutions
- Aggressively treat acidosis
- 1 tab K-phos neutral 250mg Q hour x 5 doses
- Each tab contains phosphorus 8 mmol, Na 13 mEq, K1.1 mEq
- Recheck serum phosphate after last dose, and repeat dosing if continues to be <2 mg/dl
- NOT able to take PO
- Minimize or eliminate all dextrose-containing IV solutions
- Aggressively treat acidosis
- Give 15 mmol of IV potassium phosphate over 2.5 hours (contains 22 mEq K)
- Peripheral administration may cause burning at injection site
- Consider central venous administration, if available
- Repeat dosing regimen if serum phosphate remains <2 mg/dl
- Serum phosphate <1 mg/dl
- Minimize or eliminate all dextrose-containing IV solutions
- Exceptions: vasopressors, sedatives, analgesics, antibiotics, blood products, NS
- Aggressively treat acidosis
- Give 45 mmol of IV potassium phosphate over 7 hours (contains 66 mEq of K)
- Peripheral administration may cause burning at injection site
- Consider central venous administration, if available
- If patient can tolerat PO, ALSO follow steps 1 above
- Recheck serum phosphate after infusion
- Repeat IV administration if <1 mg/dl
- Consider oral administration if >1mg and <2 mg/dl