title: Influence of traumatic brain injury on potassium and phosphorus homeostasis in critically ill multiple trauma patients.
abstract: OBJECTIVE
  The intent of this study was to ascertain whether multiple trauma patients with traumatic brain injury (TBI) had lower serum concentrations of potassium and phosphorus and required more aggressive supplementation than multiple trauma patients without TBI.
  
  
  METHODS
  Ventilator-dependent adult patients without renal impairment who were admitted to the trauma intensive care unit or neurosurgical intensive care unit and who received enteral nutrition were evaluated for the first 14 d after hospital admission. Patients were grouped according to the presence or absence of TBI. Target serum concentrations for potassium and phosphorus were 4 mEq/L and 4 mg/dL, respectively. Electrolyte repletion therapy was given according to the nutritional support service guidelines.
  
  
  RESULTS
  Fifty trauma patients (25 with and without TBI) were studied. Daily serum potassium concentrations were consistently lower for those with TBI (P < or = 0.001), whereas the mean net potassium intake was greater (1.3 +/- 0.5 versus 0.7 +/- 0.3 mEq x kg(-1) x d(-1), respectively, P < or = 0.001). Serial serum phosphorus concentrations were similar between groups (P = NS) except for a significantly lower serum phosphorus concentration for trauma patients with TBI on day 3 after hospital admission (2.5 +/- 0.5 versus 2.9 +/- 0.7 mg/dL, respectively, P < or = 0.05). However, the mean net phosphorus intake was significantly greater for trauma patients with TBI (0.65 +/- 0.25 versus 0.45 +/- 0.17 mmol x kg(-1) x d(-1), P < or = 0.001).
  
  
  CONCLUSIONS
  Potassium and phosphorus requirements are greater for multiple trauma patients with TBI compared with those without TBI.
authors.affiliation: Department of Clinical Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Lindsey
authors.forename: Rex O
authors.initials: RO
authors.lastname: Brown
authors.forename: George O
authors.initials: GO
authors.lastname: Maish
authors.forename: Martin A
authors.initials: MA
authors.lastname: Croce
authors.forename: Gayle
authors.initials: G
authors.lastname: Minard
authors.forename: Roland N
authors.initials: RN
authors.lastname: Dickerson
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000097:blood* / Q000188:drug therapy; D016638:Critical Illness; D005260:Female; D006706:Homeostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000097:blood* / Q000188:drug therapy; D018673:Nutrition Policy; D010758:Phosphorus / Q000008:administration & dosage / Q000097:blood*; D011188:Potassium / Q000008:administration & dosage / Q000097:blood*; D055815:Young Adult
chemical_list: D010758:Phosphorus; D011188:Potassium