title: Biochemical effects of phosphate-containing replacement fluid for continuous venovenous hemofiltration.
abstract: OBJECTIVE
  To examine biochemical effects of phosphate-containing replacement fluid (Phoxilium(®)) for continuous venovenous hemofiltration (CVVH).
  
  
  METHODS
  Retrospective comparison of respective serum biochemistry with sequential use of Accusol™ and Phoxilium, each over 48 h of CVVH.
  
  
  RESULTS
  We studied 15 critically ill patients. Accusol was switched to Phoxilium after 5 (4-8) days of CVVH. Respective serum biochemistry after 36-42 h of Accusol versus Phoxilium were: phosphate 1.02 (0.82-1.15) versus 1.44 (1.23-1.78) mmol/l, ionized calcium 1.28 (1.22-1.32) versus 1.12 (1.06-1.21) mmol/l, bicarbonate 24 (23-25) versus 20 (19-22) mmol/l, base excess 0 (-2 to 1) versus -4 (-6 to -3) mmol/l (p < 0.001). Cumulative phosphate intakes during respective periods were 69.6 (56.6-76.6) versus 67.2 (46.6-79.0) mmol (p = 0.45). Plasma strong ion differences were narrower with Phoxilium (p < 0.05), with similar strong ion gaps. No additional intravenous phosphate was given during Phoxilium use. Seven patients had serum phosphate >1.44 mmol/l.
  
  
  CONCLUSIONS
  Phoxilium versus Accusol use during CVVH effectively prevented hypophosphatemia but contributed to mild hyperphosphatemia, and is associated with relative hypocalcemia and metabolic acidosis.
authors.affiliation: Department of Intensive Care, Austin Health, Melbourne, Vic., Australia.
authors.forename: Horng-Ruey
authors.initials: HR
authors.lastname: Chua
authors.forename: Ian
authors.initials: I
authors.lastname: Baldwin
authors.forename: Lisa
authors.initials: L
authors.lastname: Ho
authors.forename: Allison
authors.initials: A
authors.lastname: Collins
authors.forename: Helen
authors.initials: H
authors.lastname: Allsep
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
mesh_terms: D018806:APACHE; D058186:Acute Kidney Injury / Q000097:blood / Q000150:complications / Q000628:therapy; D000368:Aged; D004573:Electrolytes / Q000097:blood / Q000737:chemistry; D005260:Female; D015312:Hemodialysis Solutions / Q000737:chemistry*; D006440:Hemofiltration / Q000009:adverse effects / Q000379:methods; D006801:Humans; D017674:Hypophosphatemia / Q000209:etiology / Q000517:prevention & control; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood / Q000737:chemistry*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D004573:Electrolytes; D015312:Hemodialysis Solutions; D010710:Phosphates