Hypophosphataemia causing profound cardiac failure after cardiac surgery.
We report the case of a patient who developed severe cardiac failure after cardiac surgery and required high-dose inotrope infusion. The patient was found to have significant hypophosphataemia and high insulin requirements immediately after surgery. On giving intravenous phosphate, there was a rapid decrease in inotrope requirement and improved glycaemic control. This occurrence raises questions about the cause of hypophosphataemia after cardiac surgery, the possible need for pre-operative plasma phosphate measurement and whether phosphate replacement should be part of the standard management of postoperative hypophosphataemia.
Heames
R M
RM
Shackleton Department of Anaesthesia, Southampton Hospitals NHS Trust, Southampton, UK. richard@heames.co.uk
Cope
R A
RA
D000368:Aged; D001026:Coronary Artery Bypass; D017809:Fatal Outcome; D005260:Female; D006333:Heart Failure / Q000209:etiology*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D017674:Hypophosphatemia / Q000150:complications* / Q000188:drug therapy; D010710:Phosphates / Q000627:therapeutic use; D011183:Postoperative Complications / Q000188:drug therapy
D010710:Phosphates