Hypophosphatemia and risk of refeeding syndrome in critically ill patients before and after nutritional therapy
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista da Associação Médica Brasileira (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302020000901241 |
Resumo: | Summary OBJECTIVE: To investigate the prevalence of hypophosphatemia as a marker of refeeding syndrome (RFS) before and after the start of nutritional therapy (NT) in critically ill patients. METHODS: Retrospective cohort study including 917 adult patients admitted at the intensive care unit (ICU) of a tertiary hospital in Cuiabá-MT/Brasil. We assessed the frequency of hypophosphatemia (phosphorus <2.5mg/dl) as a risk marker for RFS. Serum phosphorus levels were measured and compared at admission (P1) and after the start of NT (P2). RESULTS: We observed a significant increase (36.3%) of hypophosphatemia and, consequently, a greater risk of RFS from P1 to P2 (25.6 vs 34.9%; p<0.001). After the start of NT, malnourished patients had a greater fall of serum phosphorus. Patients receiving NT had an approximately 1.5 times greater risk of developing RFS (OR= 1.44 95%CI 1.10-1,89; p= 0.01) when compared to those who received an oral diet. Parenteral nutrition was more associated with hypophosphatemia than either enteral nutrition (p=0,001) or parenteral nutrition supplemented with enteral nutrition (p=0,002). CONCLUSION: The frequency of critically ill patients with hypophosphatemia and at risk for RFS on admission is high and this risk increases after the start of NT, especially in malnourished patients and those receiving parenteral nutrition. |
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Hypophosphatemia and risk of refeeding syndrome in critically ill patients before and after nutritional therapyCritical careHypophosphatemiaRefeeding SyndromeMalnourishedNutritional TherapySummary OBJECTIVE: To investigate the prevalence of hypophosphatemia as a marker of refeeding syndrome (RFS) before and after the start of nutritional therapy (NT) in critically ill patients. METHODS: Retrospective cohort study including 917 adult patients admitted at the intensive care unit (ICU) of a tertiary hospital in Cuiabá-MT/Brasil. We assessed the frequency of hypophosphatemia (phosphorus <2.5mg/dl) as a risk marker for RFS. Serum phosphorus levels were measured and compared at admission (P1) and after the start of NT (P2). RESULTS: We observed a significant increase (36.3%) of hypophosphatemia and, consequently, a greater risk of RFS from P1 to P2 (25.6 vs 34.9%; p<0.001). After the start of NT, malnourished patients had a greater fall of serum phosphorus. Patients receiving NT had an approximately 1.5 times greater risk of developing RFS (OR= 1.44 95%CI 1.10-1,89; p= 0.01) when compared to those who received an oral diet. Parenteral nutrition was more associated with hypophosphatemia than either enteral nutrition (p=0,001) or parenteral nutrition supplemented with enteral nutrition (p=0,002). CONCLUSION: The frequency of critically ill patients with hypophosphatemia and at risk for RFS on admission is high and this risk increases after the start of NT, especially in malnourished patients and those receiving parenteral nutrition.Associação Médica Brasileira2020-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302020000901241Revista da Associação Médica Brasileira v.66 n.9 2020reponame:Revista da Associação Médica Brasileira (Online)instname:Associação Médica Brasileira (AMB)instacron:AMB10.1590/1806-9282.66.9.1241info:eu-repo/semantics/openAccessRibeiro,Amanda CoelhoDock-Nascimento,Diana BorgesSilva Jr.,João ManoelCaporossi,CervantesAguilar-Nascimento,José Eduardo deeng2020-11-04T00:00:00Zoai:scielo:S0104-42302020000901241Revistahttps://ramb.amb.org.br/ultimas-edicoes/#https://old.scielo.br/oai/scielo-oai.php||ramb@amb.org.br1806-92820104-4230opendoar:2020-11-04T00:00Revista da Associação Médica Brasileira (Online) - Associação Médica Brasileira (AMB)false |
dc.title.none.fl_str_mv |
Hypophosphatemia and risk of refeeding syndrome in critically ill patients before and after nutritional therapy |
title |
Hypophosphatemia and risk of refeeding syndrome in critically ill patients before and after nutritional therapy |
spellingShingle |
Hypophosphatemia and risk of refeeding syndrome in critically ill patients before and after nutritional therapy Ribeiro,Amanda Coelho Critical care Hypophosphatemia Refeeding Syndrome Malnourished Nutritional Therapy |
title_short |
Hypophosphatemia and risk of refeeding syndrome in critically ill patients before and after nutritional therapy |
title_full |
Hypophosphatemia and risk of refeeding syndrome in critically ill patients before and after nutritional therapy |
title_fullStr |
Hypophosphatemia and risk of refeeding syndrome in critically ill patients before and after nutritional therapy |
title_full_unstemmed |
Hypophosphatemia and risk of refeeding syndrome in critically ill patients before and after nutritional therapy |
title_sort |
Hypophosphatemia and risk of refeeding syndrome in critically ill patients before and after nutritional therapy |
author |
Ribeiro,Amanda Coelho |
author_facet |
Ribeiro,Amanda Coelho Dock-Nascimento,Diana Borges Silva Jr.,João Manoel Caporossi,Cervantes Aguilar-Nascimento,José Eduardo de |
author_role |
author |
author2 |
Dock-Nascimento,Diana Borges Silva Jr.,João Manoel Caporossi,Cervantes Aguilar-Nascimento,José Eduardo de |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Ribeiro,Amanda Coelho Dock-Nascimento,Diana Borges Silva Jr.,João Manoel Caporossi,Cervantes Aguilar-Nascimento,José Eduardo de |
dc.subject.por.fl_str_mv |
Critical care Hypophosphatemia Refeeding Syndrome Malnourished Nutritional Therapy |
topic |
Critical care Hypophosphatemia Refeeding Syndrome Malnourished Nutritional Therapy |
description |
Summary OBJECTIVE: To investigate the prevalence of hypophosphatemia as a marker of refeeding syndrome (RFS) before and after the start of nutritional therapy (NT) in critically ill patients. METHODS: Retrospective cohort study including 917 adult patients admitted at the intensive care unit (ICU) of a tertiary hospital in Cuiabá-MT/Brasil. We assessed the frequency of hypophosphatemia (phosphorus <2.5mg/dl) as a risk marker for RFS. Serum phosphorus levels were measured and compared at admission (P1) and after the start of NT (P2). RESULTS: We observed a significant increase (36.3%) of hypophosphatemia and, consequently, a greater risk of RFS from P1 to P2 (25.6 vs 34.9%; p<0.001). After the start of NT, malnourished patients had a greater fall of serum phosphorus. Patients receiving NT had an approximately 1.5 times greater risk of developing RFS (OR= 1.44 95%CI 1.10-1,89; p= 0.01) when compared to those who received an oral diet. Parenteral nutrition was more associated with hypophosphatemia than either enteral nutrition (p=0,001) or parenteral nutrition supplemented with enteral nutrition (p=0,002). CONCLUSION: The frequency of critically ill patients with hypophosphatemia and at risk for RFS on admission is high and this risk increases after the start of NT, especially in malnourished patients and those receiving parenteral nutrition. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-09-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302020000901241 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302020000901241 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1806-9282.66.9.1241 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Médica Brasileira |
publisher.none.fl_str_mv |
Associação Médica Brasileira |
dc.source.none.fl_str_mv |
Revista da Associação Médica Brasileira v.66 n.9 2020 reponame:Revista da Associação Médica Brasileira (Online) instname:Associação Médica Brasileira (AMB) instacron:AMB |
instname_str |
Associação Médica Brasileira (AMB) |
instacron_str |
AMB |
institution |
AMB |
reponame_str |
Revista da Associação Médica Brasileira (Online) |
collection |
Revista da Associação Médica Brasileira (Online) |
repository.name.fl_str_mv |
Revista da Associação Médica Brasileira (Online) - Associação Médica Brasileira (AMB) |
repository.mail.fl_str_mv |
||ramb@amb.org.br |
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1754212835245686784 |