Saturday June 3, 2006
Q; Which one electrolyte you will be worried most in patients on TPN (Total Parenteral Nutrition) ?
A; Phosphate. About 33% of patients on TPN develop hypophosphatemia despite supplemented in solution. Patients who require insulin during TPN, or have a history of alcoholism, chronic weight loss, cancer and on diuretic therapy are at increased risk of hypophosphatemia, which also may manifest as "Refeeding syndrome". Serum phophate level below 1.5 mg/dl ( .5 mmol/L), can manifest symptoms of refeeding syndrome.
Read interesting editorial, Refeeding syndrome, Is underdiagnosed and undertreated, but treatable , from BMJ. ( BMJ 2004;328:908-909 )
References: click to get abstract/article
1. Refeeding syndrome: life-threatening, underdiagnosed, but treatable, QJM, April 1, 2005; 98(4): 318 - 319.