Refeeding syndrome: effective and safe treatment with Phosphates Polyfusor.

Abstract

BACKGROUND:

Severe hypophosphataemia associated with refeeding syndrome requires treatment with intravenous phosphate to prevent potentially life-threatening complications. However, evidence for replacement regimens is limited and current regimens are complex and replace phosphate inadequately.

AIM:

To assess the effectiveness and safety of 50 mmol intravenous phosphate infusion, given as a 'Phosphates Polyfusor', for the treatment of severe hypophosphataemia in refeeding syndrome.

METHODS:

Patients with refeeding syndrome and normal renal function received a Phosphates Polyfusor infusion for the treatment of severe hypophosphataemia (< 0.50 mmol/L). The outcome measures were serial serum phosphate, creatinine and calcium concentrations for 4 days following phosphate infusion and adverse events.

RESULTS:

Over 2 years, 30 patients were treated. Following treatment, 37% of cases had a normal serum phosphate concentration and 73% had a serum phosphate concentration of > 0.5 mmol/L within 24 h. Ten patients required more than one Phosphates Polyfusor infusion. Within 72 h, 93% of cases had achieved a serum phosphate concentration of > or = 0.50 mmol/L. No patient developed renal failure. Three episodes of transient mild hyperphosphataemia were recorded. Four patients developed mild hypocalcaemia.

CONCLUSIONS:

This is the largest published series of the use of intravenous phosphate for the treatment of severe hypophosphataemia (< 0.50 mmol/L), and is the most effective regimen described. All patients had refeeding syndrome and were managed on general wards.

• Authors: A Terlevich, S D Hearing, W W Woltersdorf, C Smyth, D Reid, E McCullagh, A Day, C S J Probert
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 17 Issue 10 Pg. 1325-9 (May 15 2003) ISSN: 0269-2813 [Print] England
• PMID: 12755846 (Publication Type: Journal Article)

Chemical References

• Phosphates

Topics

• Feeding Methods
• Female
• Humans
• Hypophosphatemia (complications, drug therapy)
• Infusions, Intravenous
• Male
• Middle Aged
• Nutrition Disorders (drug therapy)
• Phosphates (administration & dosage)
• Treatment Outcome