P436 - HYPOPHOSPHATEMIA IN MECHANICALLY VENTILATED POLYTRAUMA PATIENTS IN A TRAUMA CRITICAL CARE UNIT: INCIDENCE AND RISK FACTORS FOR REFEEDING SYNDROMEHOSPITAL DE TRAUMA MANUEL GIAGNI. ASUNCIÓN, PARAGUAY

P436

HYPOPHOSPHATEMIA IN MECHANICALLY VENTILATED POLYTRAUMA PATIENTS IN A TRAUMA CRITICAL CARE UNIT: INCIDENCE AND RISK FACTORS FOR REFEEDING SYNDROME

HOSPITAL DE TRAUMA MANUEL GIAGNI. ASUNCIÓN, PARAGUAY

R. SALINAS^1,2,*, R. FRANCO², T. BAEZ¹, R. FIGUEREDO²

¹HOSPITAL DE TRAUMA MANUEL GIAGNI, ²SOCIEDAD PARAGUAYA DE NUTRICION , ASUNCION , Paraguay

Rationale: What is the incidence of hypophosphatemia and the risk factors associated with refeeding syndrome in mechanically ventilated polytrauma patients in an intensive care unit?

Methods: Prospective observational study conducted at the Hospital in Paraguay from October 2024 to March 2025. A total of 83 adult polytrauma patients admitted to the Intensive Care Unit, requiring mechanical ventilation for ≥72 hours with normal baseline serum phosphate levels, were included. pH and PaCO₂, biochemical markers, and caloric and protein intake were recorded. Hypophosphatemia was defined as serum phosphate <0.8 mmol/L or a ≥30% decrease from baseline. Statistical analysis included Chi-square test, Student’s t-test, or Mann-Whitney U test, with p <0.05 considered statistically significant.

Results: The incidence of hypophosphatemia was 14.5% (n = 12). The mean age was 41.2 ± 11.7 years, and 84.3% were male (n = 70). In the hypophosphatemia group, phosphate levels decreased from 3.12 ± 0.91 to 2.09 ± 0.63 mg/dL (a 33% reduction). No statistically significant differences were observed in mean caloric intake (18.0 ± 3.1 vs. 18.5 ± 3.9 kcal/kg/day, p = 0.38) or in achieving caloric targets (75% in both groups). Mean pH (7.42 ± 0.03 vs. 7.40 ± 0.04) and PaCO₂ (36.9 ± 3.1 vs. 38.6 ± 3.2 mmHg) values were similar between groups, although a non-significant trend toward respiratory alkalosis was observed in patients with hypophosphatemia (p = 0.26).

Conclusion: The incidence of early hypophosphatemia in critically ill mechanically ventilated polytrauma patients was low (14.5%), with no significant association with initial caloric intake or acid-base disorders.

Disclosure of Interest: None declared