The Internet Book of Critical Care Podcast IBCC Episode 36 - All things Phosphate
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May 9, 2019 Explore the correlation between high and low phosphatemia. Causes and symptoms of hypophosphatemia, checking phosphate levels in the ICU, and cautions when treating phosphate-related conditions. Understanding the relationship between phosphate and calcium and the occurrence of electrolyte disorders.
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Intracellular Phosphorus Importance
- 99% of phosphorus is inside cells where it is crucial for function.
- Serum phosphate levels may not reflect intracellular deficiency, making diagnosis tricky.
When to Check Phosphate Levels
- Check phosphate levels on ICU admission and in patients at risk for refeeding syndrome or diabetic ketoacidosis.
- Also monitor patients undergoing continuous renal replacement therapy due to phosphate losses.
Choosing IV vs Oral Phosphate
- Use intravenous phosphate for severe or symptomatic hypophosphatemia or when enteral access is unavailable.
- Oral phosphate is safer and preferred for mild to moderate cases and maintenance therapy.