v
Dr. Zain Ahmar, Dr. Attiya Iqbal, Dr. Esha Ahmad
Objective: Phosphorus plays an important role in metabolism as an intracellular anion, an enzyme component and a component of phosphorylated intermediates, and phosphorus is a component of cell membranes, nucleic acids and nuclear proteins. Hypophosphatemia is the most neglected electrolyte deficiency in our medical practice. Some clinical conditions and medications can cause hypophosphatemia. Transient hypophosphatemia rarely causes symptoms, but severe hypophosphatemia can contribute to increased morbidity and mortality in serious patients. The aim of this study was to determine the prevalence of hypophosphatemia among critically ill patients. Place and Duration: In the Medicine Unit of ICU of Bahawal Victoria Hospital (BVH) Bahawalpur for one year duration from March 2019 to February 2020. Material and Methods: 50 critical patients were admitted to the medical and intensive care unit within 12 months. The average age was 49.5 ± 17.4. Thirty-one (62%) patients were men and 19 (38%) were women. At admission, 16 patients (16%) had hypophosphatemia (<2.5 mg / dl) and eighty-four (84%) had normal phosphate or hyperphosphataemia. The average phosphate concentration was 3.27 ± 0.79 mg / dl (range 1.8 to 5.1 mg / dl). The occurrence of hypophosphatemia can be compared with international studies. Results: In our study, an important clinical diagnosis of hypophosphatemia was diabetic ketoacidosis (16%), respiratory alkalosis (18%), sepsis (32%), chronic obstructive pulmonary disease (32%), respiratory failure (42%) and cirrhotic coma. (38%), renal failure (10%). The incidence of hypophosphatemia was higher in patients with breathing difficulties (p = 0.047). Patients receiving the Ss2 agonist had low serum phosphate levels, although not statistically significant, while patients with renal failure had higher serum phosphate levels. The incidence of hypophosphatemia was higher in patients with more than one disease. Mortality was higher in patients with hypophosphatemic sepsis (32%). In 60% of patients, 19 (38%) had mechanical ventilation, hypophosphatemia, hepatic coma and respiratory alkalosis. Serum calcium and albumin levels were low in patients with hypophosphatemia. No serious hypophosphatemia (<1.5 mg / dl) was observed in this study. Hemoglobin levels were not significantly changed below serum phosphate levels. Conclusion: The incidence of hypophosphatemia was higher in patients with dyspnea. Hypophosphatemia was 15% in critically ill patients admitted to medical departments and intensive care. Hypophosphatemia is more susceptible to development in patients with sepsis, respiratory failure and chronic obstructive pulmonary disease. Key words: hypophosphatemia, phosphorus, critical patients.