Hypophosphatemia in critically ill children

Hypophosphatemia in critically ill children

Alternative title Hipofosfatemia em crianças gravemente doentes
Author Menezes, Fernanda Souza de Autor UNIFESP Google Scholar
Leite, Heitor Pons Autor UNIFESP Google Scholar
Fernandez, Juliana Autor UNIFESP Google Scholar
Benzecry, Silvana Gomes Autor UNIFESP Google Scholar
Carvalho, Werther Brunow de Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract The purpose of this paper is to review clinical studies on hypophosphatemia in pediatric intensive care unit patients with a view to verifying prevalence and risk factors associated with this disorder. We searched the computerized bibliographic databases Medline, Embase, Cochrane Library, and LILACS to identify eligible studies. Search terms included critically ill, pediatric intensive care, trauma, sepsis, infectious diseases, malnutrition, inflammatory response, surgery, starvation, respiratory failure, diuretic, steroid, antiacid therapy, mechanical ventilation. The search period covered those clinical trials published from January 1990 to January 2004. Studies concerning endocrinological disorders, genetic syndromes, rickets, renal diseases, anorexia nervosa, alcohol abuse, and prematurity were not included in this review. Out of 27 studies retrieved, only 8 involved pediatric patients, and most of these were case reports. One clinical trial and one retrospective study were identified. The prevalence of hypophosphatemia exceeded 50%. The commonly associated factors in most patients with hypophosphatemia were refeeding syndrome, malnutrition, sepsis, trauma, and diuretic and steroid therapy. Given the high prevalence, clinical manifestations, and multiple risk factors, the early identification of this disorder in critically ill children is crucial for adequate replacement therapy and also to avoid complications.

Este estudo objetivou realizar revisão da literatura para verificar prevalência, fatores de risco e condições clínicas associadas à hipofosfatemia em crianças gravemente doentes. Para a pesquisa foram utilizadas as bases de dados Medline, Embase, Cochrane Library, Lilacs abrangendo estudos clínicos publicados de janeiro de 1990 a janeiro de 2004. Os termos utilizados para pesquisa foram: critically ill, pediatric intensive care, trauma, sepsis, infectious diseases, malnutrition, inflammatory response, surgery, starvation, respiratory failure, diuretic, steroid, antiacid therapy, mechanical ventilation. Foram excluídos estudos referentes a distúrbios endócrinos, síndromes genéticas, raquitismo, nefropatias, anorexia nervosa, alcoolismo e prematuridade. Dos 27 artigos inicialmente identificados, 8 referiam-se à faixa etária pediátrica, sendo a maioria deles relatos de casos isolados. Nos estudos clínicos selecionados, a prevalência de hipofosfatemia foi superior a 50%. Os principais fatores associados à hipofosfatemia foram realimentação, desnutrição, sepse, trauma, uso de diuréticos e corticoesteróides. Considerando-se a elevada prevalência, as repercussões clínicas e os múltiplos fatores de risco para hipofosfatemia em crianças internadas em unidade de cuidados intensivos, a identificação precoce de pacientes suscetíveis a esse distúrbio é essencial para o tratamento oportuno e prevenção de complicações.
Keywords Hypophosphatemia
Children
Malnutrition
Pediatric intensive care unit
Critically ill
Hipofosfatemia
Crianças
Desnutrição
Unidade de Terapia Intensiva Pediátrica
Gravemente doente
Language English
Date 2004-01-01
Published in Revista do Hospital das Clínicas. Faculdade de Medicina / Universidade de São Paulo - FM/USP, v. 59, n. 5, p. 306-311, 2004.
ISSN 0041-8781 (Sherpa/Romeo)
Publisher Faculdade de Medicina / Universidade de São Paulo - FM/USP
Extent 306-311
Origin http://dx.doi.org/10.1590/S0041-87812004000500015
Access rights Open access Open Access
Type Article
SciELO ID S0041-87812004000500015 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/1967

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