Association between hypophosphatemia and cardiac arrhythmias in the early stages of sepsis.
BACKGROUND: The purpose of this study was to evaluate a possible association between serum phosphate levels and the incidence of cardiac arrhythmias in the early stages of sepsis. METHODS: We conducted a prospective, controlled study in the General Intensive Care Unit (GICU) of a university hospital. Sixteen patients with sepsis, but without any previous cardiac disease, were studied during their first 24 h in the GICU. Patients were connected to a continuous ECG recording device. Blood samples for serum phosphate level determinations were drawn during the first 6 h after admission to the unit. RESULTS: Ten of 16 patients had 21 episodes of atrial and ventricular arrhythmias. These patients had higher mean Apache II scores (20.2+/-6.2) than the six patients without arrhythmias (13.2+/-1.7; P<0.05) and significantly lower mean phosphate levels (0.73+/-0.16 vs. 1.02+/-0.32 mmol/l; P<0.03). No association was found between serum phosphate levels and mortality among patients with arrhythmias, or when all survivors (with and without arrhythmia) were compared to all non-survivors. CONCLUSIONS: The results indicate that patients with sepsis and low serum phosphate levels are at a greater risk of developing cardiac arrhythmias. We suggest that phosphate supplementation in the early stages of sepsis may prevent cardiac arrhythmias.
Schwartz
Andrei
A
General Intensive Care Unit, Division of Anesthesiology, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101, Beer-Sheva, Israel
Gurman
Gabriel
G
Cohen
Gizella
G
Gilutz
Harel
H
Brill
Silviu
S
Schily
Markus
M
Gurevitch
Boris
B
Shoenfeld
Yehuda
Y