title: 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.
  
  
  OBJECTIVE
  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.affiliation: Department of Gastroenterology, Bristol Royal Infirmary, Bristol, UK.
authors.forename: A
authors.initials: A
authors.lastname: Terlevich
authors.forename: S D
authors.initials: SD
authors.lastname: Hearing
authors.forename: W W
authors.initials: WW
authors.lastname: Woltersdorf
authors.forename: C
authors.initials: C
authors.lastname: Smyth
authors.forename: D
authors.initials: D
authors.lastname: Reid
authors.forename: E
authors.initials: E
authors.lastname: McCullagh
authors.forename: A
authors.initials: A
authors.lastname: Day
authors.forename: C S J
authors.initials: CS
authors.lastname: Probert
mesh_terms: D005248:Feeding Methods; D005260:Female; D006801:Humans; D017674:Hypophosphatemia / Q000150:complications / Q000188:drug therapy*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000188:drug therapy*; D010710:Phosphates / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D010710:Phosphates