title: Hypophosphatemia in critically ill children.
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.
authors.affiliation: Discipline of Nutrition and Metabolism and the Pediatric Intensive Care Unit, Department of Pediatrics, Federal University of São Paulo - São Paulo/SP, Brazil.
authors.forename: Fernanda Souza
authors.initials: FS
authors.lastname: de Menezes
authors.forename: Heitor Pons
authors.initials: HP
authors.lastname: Leite
authors.forename: Juliana
authors.initials: J
authors.lastname: Fernandez
authors.forename: Silvana Gomes
authors.initials: SG
authors.lastname: Benzecry
authors.forename: Werther Brunow
authors.initials: WB
authors.lastname: de Carvalho
mesh_terms: D002648:Child; D002986:Clinical Trials as Topic; D003422:Critical Care; D016638:Critical Illness; D006801:Humans; D017674:Hypophosphatemia / Q000097:blood / Q000209:etiology*; D015278:Intensive Care Units, Pediatric; D012307:Risk Factors