Evaluation of a Novel Enteral Phosphorus Therapy with Enteral Nutrition during a National Intravenous Sodium Phosphate Shortage
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable * | Lower Dose | Higher Dose | p |
---|---|---|---|
N | 22 | 11 | - |
Age, y | 49 [29, 64] | 34 [27, 48] | 0.331 |
Actual weight, kg | 83 [68, 102] | 82 [72, 90] | 0.789 |
Ideal body weight, kg | 65 (59, 75) | 71 (66, 78) | 0.292 |
Adjusted dosing weight, kg | 76 [68, 85] | 75 [72, 84] | 0.619 |
Body mass index, kg/m2 | 26.3 [23.0, 33.1] | 27.0 [24.5, 28.8] | 0.717 |
Sex, male/female, n/n | 14/8 | 9/2 | 0.430 |
Race | |||
Black, n | 13 | 7 | 0.586 |
White, n | 7 | 4 | |
Hispanic, n | 2 | 0 | |
Admission diagnosis | |||
Motor vehicle collision, n | 16 | 7 | 0.329 |
GSW/KSW, n | 2 | 3 | |
Fall/assault, n | 1 | 1 | |
Other, n | 3 | 0 | |
Severe TBI with ICP monitoring, n (%) | 7 (32%) | 2 (18%) | 0.681 |
Ventilator dependent, n | 21 (95%) | 11 (100%) | 1.000 |
TICU length of stay, d | 14 [9, 19] | 14 [12, 18] | 0.515 |
Hospital length of stay, d | 28 [18, 45] | 21 [19, 41] | 0.390 |
Ventilator dependent, n (%) | 21 (95%) | 11 (100%) | 1.000 |
Survived, n (%) | 17 (77%) | 10 (91%) | 0.637 |
Serum potassium, mEq/L | 4.2 [4.0, 4.3] | 4.2 [4.0, 4.4] | 0.546 |
mmol/L | 4.2 [4.0, 4.3] | 4.2 [4.0, 4.4] | |
White blood cell count, cells/µm3 | 10.7 [9.3, 13.5] | 10.5 [7.8. 14.3] | 0.717 |
Serum magnesium, mg/dL | 2.0 [2.0, 2.1] | 1.8 [1.7, 2.1] | 0.055 |
mmol/L | 0.82 [0.82, 0.86] | 0.74 [0.70, 0.86] | |
C-reactive protein, mg/dL | 25.0 [17.9, 34.3] | 18.1 [10.9, 31.8] | 0.172 |
mg/L | 250 [179, 343] | 181 [109, 318] | |
Prealbumin, mg/dL | 9.0 [4.5, 13.5] | 10.0 [7.0, 14.3] | 0.364 |
mg/L | 90 [45, 135] | 100 [70, 143] | |
Serum creatinine, mg/dL | 0.8 [0.6, 1.0] | 0.8 [0.7, 0.9] | 0.907 |
µmol/L | 71 [53, 88] | 77 [62, 80] | |
Serum urea nitrogen, mg/dL | 18 [13, 27] | 18 [10, 27] | 0.804 |
mmol/L | 6.4 [4.6, 9.6] | 6.4 [3.6, 9.6] | |
Serum glucose, mg/dL | 135 [113, 164] | 113 [104, 122] | 0.070 |
mmol/L | 7.5 [6.3, 9.1] | 6.3 [5.8, 6.8] | |
Total fluid intake, L/d | 2.9 [2.2, 3.5] | 3.1 [1.8, 3.4] | 0.954 |
Total fluid output, L/d | 1.9 [1.4, 3.0] | 2.2 [1.1, 3.7] | 0.554 |
Received vasopressors during EN, n (%) | 2 (9%) | 1 (9%) | 1.000 |
Variable * | Lower Dose | Higher Dose | p |
---|---|---|---|
Number of patients, n | 22 | 11 | - |
Phosphorus dose, mmol | 34 | 68 | - |
Phosphorus dose, mmol/kg dosing weight | 0.45 [0.40, 0.50] | 0.91 [0.81, 0.94] | 0.001 |
EN phosphorus intake, mmol ¶ | 19.5 [8.8, 34] | 24 [12, 33] | 0.789 |
Day of EN, d ¶ | 2 [1, 7] | 2 [1, 4] | 0.556 |
TICU day, d ¶, | 5 [3, 10] | 4 [2, 6] | 0.317 |
Caloric intake, kcals/d ¶ | 899 [423, 1405] | 1035 [443, 1513] | 0.717 |
Carbohydrate intake, g/d ¶ | 64 [39, 136] | 107 [55, 161] | 0.480 |
Insulin intake, units/d ¶ | 0 [0, 3] | 0 [0, 0] | 0.477 |
Arterial pH pre-dose | 7.42 [7.36, 7.47] | 7.42 [7.37, 7.45] | 0.560 |
Arterial pH post-dose | 7.45 [7.39, 7.49] | 7.44 [7.29, 7.50] | 0.830 |
Initial serum phosphorus, mg/dL | 2.6 [2.4, 2.8] | 2.5 [2.1, 2.8] | 0.465 |
mmol/L | 0.84 [0.77, 0.90] | 0.81 [0.68, 0.90] | |
Final serum phosphorus, mg/dL | 2.8 [1.9, 3.3] | 2.9 [2.2, 3.0] | 0.878 |
mmol/L | 0.90 [0.61, 1.07] | 0.94 [0.71, 0.97] | |
∆ in serum phosphorus, mg/dL | 0.2 [−0.5, 0.7] | 0.6 [−0.3, 0.8] | 0.646 |
mmol/L | 0.06 [−0.16, 0.23] | 0.19 [−0.10, 0.26] | |
Improvement in serum phosphorus, n (%) | 12 (55%) | 8 (73%) | 0.436 |
Initial serum iCa, mmol/L | 1.11 [1.07, 1.17] | 1.14 [1.11, 1.15] | 0.984 |
Final serum iCa, mmol/L | 1.15 [1.09, 1.20] | 1.12 [1.08, 1.16] | 0.251 |
Diarrhea, n (%) | 3 (14%) | 0 (0%) | 0.534 |
Variable * | Responded | Not Responded | p |
---|---|---|---|
Number of patients, n | 20 | 13 | - |
Initial serum phosphorus, mg/dL | 2.6 [2.3, 2.8] | 2.6 [2.3, 2.8] | 0.811 |
mmol/L | 0.84 [0.74, 0.90] | 0.84 [0.74, 0.90] | |
Final serum phosphorus, mg/dL | 3.1 [2.9, 3.6] | 1.9 [1.6, 2.3] | 0.001 |
mmol/L | 1.0 [0.94, 1.16] | 0.61 [0.52, 0.74] | |
Phosphorus dose, mmol | 35 [35, 70] | 35 [35, 53] | 0.332 |
Phosphorus dose, mmol/kg dosing weight | 0.53 [0.44, 0.85] | 0.51 [0.42, 0.80] | 0.495 |
EN phosphorus intake, mmol/d | 16 [7, 31] | 24 [16, 35] | 0.172 |
Age, y | 36 [26, 60] | 48 [40, 66] | 0.167 |
Body mass index (kg/m2) | 27.5 [24.5, 31.5] | 25.8 [22.6, 30.0] | 0.585 |
Serum creatinine, mg/dL | 0.8 [0.6, 0.9] | 0.8 [0.8, 1.0] | 0.202 |
µmol/L | 71 [53, 80] | 71 [71, 88] | |
C-reactive protein, mg/dL ¶ | 25.0 [16.5, 34.3] | 19.6 [10.0, 29.5] | 0.144 |
mg/L ¶ | 250 [165, 343] | 196 [100, 295] | |
Prealbumin, mg/dL ¶ | 8.5 [5.8, 13.0] | 10.0 [6.0, 16.0] | 0.518 |
mg/L ¶ | 85 [58, 130] | 100 [60, 160] | |
WBC, cells/µm3 | 10.6 [9.0, 12.0] | 11.9 [9.5, 15.8] | 0.308 |
Arterial pH pre-dose | 7.42 [7.36, 7.48] | 7.40 [7.36, 7.44] | 0.639 |
Arterial pH post-dose | 7.44 [7.34, 7.47] | 7.45 [7.41, 7.51] | 0.208 |
Admit diagnosis of MVC, n (%) | 15 (75%) | 8 (62%) | 0.745 |
Traumatic brain injury, n (%) | 5 (25%) | 4 (31%) | 1.000 |
Survived, n (%) | 16 (80%) | 11 (85%) | 1.000 |
Day of EN, d ¶ | 2 [1, 4] | 2 [1, 8] | 0.955 |
TICU day, d ¶, | 4 [3, 6] | 4 [2, 11] | 0.741 |
Caloric intake, kcals/d ¶ | 703 [340, 1469] | 985 [777, 1467] | 0.261 |
Carbohydrate intake, g/d ¶ | 60 [28, 123] | 108 [63, 162] | 0.203 |
Serum glucose, mg/dL ¶ | 118 [109, 139] | 136 [115, 161] | 0.196 |
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Harris, T.D.; Farrar, J.E.; Byerly, S.; Filiberto, D.M.; Dickerson, R.N. Evaluation of a Novel Enteral Phosphorus Therapy with Enteral Nutrition during a National Intravenous Sodium Phosphate Shortage. Nutrients 2024, 16, 1394. https://doi.org/10.3390/nu16091394
Harris TD, Farrar JE, Byerly S, Filiberto DM, Dickerson RN. Evaluation of a Novel Enteral Phosphorus Therapy with Enteral Nutrition during a National Intravenous Sodium Phosphate Shortage. Nutrients. 2024; 16(9):1394. https://doi.org/10.3390/nu16091394
Chicago/Turabian StyleHarris, Tinia D., Julie E. Farrar, Saskya Byerly, Dina M. Filiberto, and Roland N. Dickerson. 2024. "Evaluation of a Novel Enteral Phosphorus Therapy with Enteral Nutrition during a National Intravenous Sodium Phosphate Shortage" Nutrients 16, no. 9: 1394. https://doi.org/10.3390/nu16091394
APA StyleHarris, T. D., Farrar, J. E., Byerly, S., Filiberto, D. M., & Dickerson, R. N. (2024). Evaluation of a Novel Enteral Phosphorus Therapy with Enteral Nutrition during a National Intravenous Sodium Phosphate Shortage. Nutrients, 16(9), 1394. https://doi.org/10.3390/nu16091394