PD226 - ADMISSION SERUM PHOSPHATE LEVELS DO NOT PREDICT NUTRITION-ASSOCIATED HYPOPHOSPHATAEMIA IN HIGH-RISK CRITICALLY ILL TRAUMA PATIENTS: A PILOT STUDY

PD226

ADMISSION SERUM PHOSPHATE LEVELS DO NOT PREDICT NUTRITION-ASSOCIATED HYPOPHOSPHATAEMIA IN HIGH-RISK CRITICALLY ILL TRAUMA PATIENTS: A PILOT STUDY

G. Nardai^1,*, C. Ferdinandy²

¹Intensive Care Unit, Manninger Jenő Trauma Centre, ²Korányi National Institute of Pulmonology, Budapest, Hungary

Rationale: The risk of refeeding syndrome is substantial in subgroups of trauma ICU patients. The aim of our study was to assess whether serum phosphate levels measured on Day 1 could predict hypophosphataemic episodes following the initiation of enteral feeding in high-risk patients.

Methods: single-centre prospective study including adult trauma patients admitted to ICU. Predefined risk factors: alcohol/drug dependence, mental disorders, age >70 years. Demographic data, comorbidities, malnutrition risk, injury data, lab parameters (serum phosphate, blood cell counts, CRP), feeding and outcome data were analysed. Enteral feeding was initiated on Day 2, and serum phosphate was measured on Days 3–4. The Mann–Whitney U test, and the chi-squared test were used, with p < 0.05 considered statistically significant.

Results: 32 patients were analysed (median age 63 years, 70% male, median BMI 26). Malnutrition risk was high in 25% of patients (NRS-2002 >3). The most common risk factor was alcohol dependence (41%), and 50% of patients had traumatic brain injury. The median ISS was 19. The median ICU LOS was 5 days, the in-hospital survival rate was 84%. Low serum phosphate levels (<0.8 mmol/L) were found in 5 patients (15%) on Day 1 and in 8 patients (42%) on Days 3–4. All patients with low phosphate levels on Days 3–4 had normal phosphate levels on admission. Patients who developed late hypophosphatemia were older (65 vs 55 years), sicker, had more severe injuries (ISS 25 vs 22), and were more likely to have alcohol dependence (78% vs 15%).

Conclusion: Nutrition-associated hypophosphatemia is common among high-risk trauma patients, but serum phosphate levels on admission may have limited value in identifying vulnerable patients. Serum phosphate measurements after the initiation of nutritional support may be particularly useful in patients with alcohol dependence.

References: .

Disclosure of Interest: None declared