PMID- 33454128 OWN - NLM STAT- MEDLINE DCOM- 20211004 LR - 20211004 IS - 1532-1983 (Electronic) IS - 0261-5614 (Linking) VI - 40 IP - 5 DP - 2021 May TI - Prevalence of hypophosphatemia in the ICU - Results of an international one-day point prevalence survey. PG - 3615-3621 LID - S0261-5614(20)30692-0 [pii] LID - 10.1016/j.clnu.2020.12.017 [doi] AB - BACKGROUND & AIMS: Hypophosphatemia (HypoP) is associated with organ dysfunction and mortality. Despite its potential severe consequences, HypoP remains poorly characterized in terms of real prevalence and timing of onset. The primary objective was to determine the prevalence of HypoP defined as blood phosphate <0.8 and < 0.65 mmol/l on one particular day at international level. METHODS: One-day point prevalence survey conducted by the Section of Metabolism, Endocrinology and Nutrition (MEN) of the European Society of Intensive Care Medicine (ESICM) during week 11-2020. RESULTS: In total, 56 adult and 4 paediatric ICUs, from 22 countries participated: 41 ICUs were mixed medico surgical, the 19 others being cardiac, medical or surgical. Phosphate measurements were performed daily in 21 ICUs, and 1-3 times per week in 39 ICUs. On D-Day 909 patients (883 adults) were present and 668/883 (75.7%) had serum/plasma phosphate determined, revealing a HypoP in 103 (15.4%) patients aged 62 [18 to 85] years. Of those, 49 patients presented phosphate <0.65 mmol/l: cases of hypophosphatemia were detected at any time of patient's ICU stay. No HypoP was observed in children. A treatment protocol existed only in 41.1% of adult ICUs, independently of ICU type, or size. Only 41/98 of the HypoP patients (29/41 of patients with phosphate <0.65 mmol/l) were receiving phosphate. CONCLUSION: HypoP is present at least in 15.4% of ICU patients, and may occur at any time during the ICU stay. The absence of phosphate repletion protocols in 60% of participating ICUs is an unexpected finding, and confirms the necessity for the development of ICU phosphate protocols and guidelines. CLINICALTRIALS IDENTIFIER: NCT04201899. CI - Copyright (c) 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved. FAU - Berger, M M AU - Berger MM AD - Lausanne University Hospital, Lausanne, Switzerland. Electronic address: Mette.Berger@chuv.ch. FAU - Appelberg, O AU - Appelberg O AD - University of Tartu, Tartu University Hospital, Tartu, Estonia. Electronic address: oskar.appelberg@gmail.com. FAU - Reintam-Blaser, A AU - Reintam-Blaser A AD - Lucerne Cantonal Hospital, Dpt of Intensive Care Medicine, Lucerne, Switzerland. Electronic address: annika.reintam.blaser@ut.ee. FAU - Ichai, C AU - Ichai C AD - Universite Cote d'Azur, Mixed Intensive Care Unit, Nice, France. Electronic address: ichai@unice.fr. FAU - Joannes-Boyau, O AU - Joannes-Boyau O AD - Centre hospitalier universitaire de Bordeaux, Bordeaux, France. Electronic address: olivier.joannes-boyau@chu-bordeaux.f. FAU - Casaer, M AU - Casaer M AD - Department of Intensive Care Medicine, University Hospital Leuven, Leuven, Belgium. Electronic address: michael.casaer@uzleuven.be. FAU - Schaller, S J AU - Schaller SJ AD - Charite, Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, And Berlin Institute of Health, Dpt of Anesthesiology and Operative Intensive Care Medicine, Berlin, Germany. Electronic address: stefan.schaller@charite.de. FAU - Gunst, J AU - Gunst J AD - KU Leuven, Dpt of Cellular and Molecular Medicine, Clinical, Dpt and Laboratory of Intensive Care Medicine, Belgium, Leuven. Electronic address: jan.gunst@kuleuven.be. FAU - Starkopf, J AU - Starkopf J AD - University of Tartu, Tartu University Hospital, Estonia. Electronic address: Joel.Starkopf@kliinikum.ee. CN - ESICM-MEN section LA - eng SI - ClinicalTrials.gov/NCT04201899 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20201229 PL - England TA - Clin Nutr JT - Clinical nutrition (Edinburgh, Scotland) JID - 8309603 SB - IM MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Child MH - Cross-Sectional Studies MH - Humans MH - Hypophosphatemia/*epidemiology MH - Intensive Care Units/*statistics & numerical data MH - Middle Aged MH - Prevalence MH - Young Adult OTO - NOTNLM OT - Critically ill OT - Electrolyte OT - Monitoring OT - Nutrition OT - Repletion OT - Standard operating procedure COIS- Conflict of interest None of the authors has any conflict to declare related to the present study. FIR - Abel, Arroyo IR - Abel A IRAD- Peru, Trujillo. Electronic address: abelsalvador@yahoo.com. FIR - Erna, Alberts IR - Erna A IRAD- the Netherlands, Amsterdam. Electronic address: erna.alberts@amsterdamumc.nl. FIR - Berger Mette, M IR - Berger Mette M IRAD- Switzerland, Lausanne. Electronic address: mette.berger@chuv.ch. FIR - Guillaume, Besch IR - Guillaume B IRAD- Dpt of Anesthesiology and Intensive Care Medicine, CHU de Besancon, and EA3920, University of Franche-Comte, France. Electronic address: gbesch@chu-besancon.fr. FIR - Costel, Besancon Bodolea IR - Costel BB IRAD- Romania, Cluj-Napoca. Electronic address: cbodolea@gmail.com. FIR - Michael, Casaer IR - Michael C IRAD- Belgium, Leuven. Electronic address: michael.casaer@uzleuven.be. FIR - Perez, Cheng Meisy IR - Perez CM IRAD- Spain, Salamanca. Electronic address: meisypch@yahoo.es. FIR - Jean-Michel, Constantin IR - Jean-Michel C IRAD- France, Paris. Electronic address: jean-michel.constanting@aphp.fr. FIR - Swarna, Deepak IR - Swarna D IRAD- India, Hyderabad. Electronic address: drksdeepak@gmail.com. FIR - de Man Angelique, M E IR - de Man Angelique ME IRAD- the Netherlands, Amsterdam. Electronic address: ame.deman@amsterdamumc.nl. FIR - Frantisek, Duska IR - Frantisek D IRAD- Czech Republic, Prague. Electronic address: fduska@yahoo.com. FIR - Patricia, Fodor IR - Patricia F IRAD- Switzerland, Zurich. Electronic address: patricia.fodor@triemli.zuerich.ch. FIR - Kristina, Fuest IR - Kristina F IRAD- Germany, Munich. Electronic address: kristina.fuest@tum.de. FIR - Thierry, Fumeaux IR - Thierry F IRAD- Switzerland, Nyon. Electronic address: thierry.fumeaux@ghol.ch. FIR - Hubert, Grand IR - Hubert G IRAD- France, Libourne. Electronic address: hubert.grand@ch-libourne.fr. FIR - Gundogan, K IR - Gundogan K IRAD- Turkey, Kayseri. Electronic address: kursatgundogan@hotmail.com. FIR - Jan, Gunst IR - Jan G IRAD- KU Leuven, Department of Cellular and Molecular Medicine, Clinical Department and Laboratory of Intensive Care Medicine, Belgium, Leuven. Electronic address: jan.gunst@kuleuven.be. FIR - Mohan, Gurjar IR - Mohan G IRAD- India, Lucknow. Electronic address: m.gurjar@rediffmail.com. FIR - Laurent, Heyer IR - Laurent H IRAD- France, Lyon. Electronic address: laurent.heyer@gmail.com. FIR - Shihan, Huq IR - Shihan H IRAD- Bangladesh, haka. Electronic address: shihan.huq@gmail.com. FIR - Carole, Ichai IR - Carole I IRAD- France, Nice. Electronic address: ichai@unice.fr. FIR - Motiul, Islam IR - Motiul I IRAD- Bangladesh, Dhaka. Electronic address: motiulshl.icu@gmail.com. FIR - Samir, Jaber IR - Samir J IRAD- France, Montpellier. Electronic address: s-jaber@chu-montpellier.fr. FIR - Nikilesh, Jain IR - Nikilesh J IRAD- India, Indore. Electronic address: nikhilesh_jin@yahoo.co.in. FIR - Matthieu, Jamme IR - Matthieu J IRAD- France, Poissy. Electronic address: matthieu.jamme@ght-yvelinesnord.fr. FIR - Ib, Jammer IR - Ib J IRAD- Norway, Bergen. Electronic address: ib.jammer@helse-bergen.no. FIR - Olivier, Joannes-Boyau IR - Olivier JB IRAD- France, Pessac. Electronic address: olivier.joannes-boyau@chu-bordeaux.fr. FIR - Veronika, Jung IR - Veronika J IRAD- Germany, Munich. Electronic address: veronika.jung@gmx.net. FIR - Inga, Karu IR - Inga K IRAD- Estonia, Tallinn. Electronic address: inga.karu@regionaalhaigla.ee. FIR - Kamal Habeeb, Keryakos Hesham IR - Kamal Habeeb KH IRAD- Egypt, El-Minya. Electronic address: keryakos.hesham@gmail.com. FIR - Gian-Reto, Kleger IR - Gian-Reto K IRAD- Switzerland, St. Gallen. Electronic address: gian-reto.kleger@kssg.ch. FIR - Tim, Krol IR - Tim K IRAD- Netherlands, Enschede. Electronic address: researchic@mst.nl. FIR - Friedrich, Kuhn Karl IR - Friedrich KK IRAD- Germany, Berlin. Electronic address: friedrich.kuhn@charite.de. FIR - Marcus, Laube IR - Marcus L IRAD- Switzerland, Biel. Electronic address: marcus.laube@szb-chb.ch. FIR - Yoann, Launey IR - Yoann L IRAD- France, Rennes. Electronic address: yoann.launey@chu-rennes.fr. FIR - Manu, Malbrain IR - Manu M IRAD- Belgium, Brussels. Electronic address: manu.malbrain@uzbrussel.be. FIR - Manrique Ezequiel IR - Manrique Ezequiel IRAD- Argentina, Cordoba. Electronic address: drmanriqueezequiel@gmail.com. FIR - Julien, Marrel IR - Julien M IRAD- Switzerland, Horgen. Electronic address: julien.marrel@see-spital.ch. FIR - Roberto, Martinez-Alejos IR - Roberto MA IRAD- France, Montpellier. Electronic address: r-martinezalejos@chu-montpellier.fr. FIR - Mongardon, Nicolas IR - Mongardon N IRAD- France, Creteil, Service d'Anesthesie-Reanimation, Hopitaux Universitaires Henri Mondor. Electronic address: nicolas.mongardon@aphp.fr. FIR - Conway, Morris Andrew IR - Conway MA IRAD- United Kingdom, Cambridge. Electronic address: mozza@doctors.org.uk. FIR - Madhu, Pahuja IR - Madhu P IRAD- India, Indore. Electronic address: mpahuja@chlhospitals.com. FIR - Fernando, Pereira IR - Fernando P IRAD- Colombia, Medellin. Electronic address: drfernandopereira@gmail.com. FIR - Gema, Perez IR - Gema P IRAD- Spain, Madrid, Hospital General Universitario Gregorio Maranon. Electronic address: gemapy09@hotmail.com. FIR - Marie-Helene, Perez IR - Marie-Helene P IRAD- Switzerland, Lausanne. Electronic address: marie-helene.perez@chuv.ch. FIR - Carmen, Pfortmuller IR - Carmen P IRAD- Switzerland, Bern. Electronic address: carmen.pfortmueller@insel.ch. FIR - Annika, Reintam Blaser IR - Annika RB IRAD- Switzerland, Lucerne. Electronic address: annika.reintam.blaser@ut.ee. FIR - Ricardo, Rosenfeld IR - Ricardo R IRAD- Brazil, Rio de Janeiro. Electronic address: ricardorosenfeld57@gmail.com. FIR - Noryani, Samat IR - Noryani S IRAD- Malaysia, Kuala Krai. Electronic address: yanims76@yahoo.com.my. FIR - Schaller Stefan, J IR - Schaller Stefan J IRAD- Germany, Berlin. Electronic address: stefan.schaller@charite.de. FIR - Shannon, Simpson IR - Shannon S IRAD- Australia, Prahran. Electronic address: ssimpson@cabrini.com.au. FIR - Kelly, Straka IR - Kelly S IRAD- Greece, Athens. Electronic address: kelstraka@gmail.com. FIR - Tamas, Szakmany IR - Tamas S IRAD- United Kingdom, Newport. Electronic address: szakmany@gmail.com. FIR - Kadri, Tamme IR - Kadri T IRAD- Estonia, Tartu. Electronic address: kadri.tamme@kliinikum.ee. FIR - Arthur, Van Zanten IR - Arthur VZ IRAD- the Netherlands, Ede. Electronic address: moonenH@zgv.nl. FIR - Vercoza, Viana Marina IR - Vercoza VM IRAD- Brazil, Porto Alegre. Electronic address: marivv1981@gmail.com. EDAT- 2021/01/18 06:00 MHDA- 2021/10/05 06:00 CRDT- 2021/01/17 20:23 PHST- 2020/10/03 00:00 [received] PHST- 2020/11/16 00:00 [revised] PHST- 2020/12/16 00:00 [accepted] PHST- 2021/01/18 06:00 [pubmed] PHST- 2021/10/05 06:00 [medline] PHST- 2021/01/17 20:23 [entrez] AID - S0261-5614(20)30692-0 [pii] AID - 10.1016/j.clnu.2020.12.017 [doi] PST - ppublish SO - Clin Nutr. 2021 May;40(5):3615-3621. doi: 10.1016/j.clnu.2020.12.017. Epub 2020 Dec 29.