Neurological complications as a sequence of Hypophosphatemia in patients receiving total parenteral Hyperalimentation

Within 7 to 10 days after initiation of total parentral hyperalimentation with solutions lacking inorganic phosphates 8 out of 12 patients were found to be significantly hypophosphatemic [serum inorganic phosphate less than 1 mg/100 ml]. Slight nervous manifistations were observed in all of the 8 patients, one of them developed severe nervous manifistations which resulted into coma and respiratory failure. His serum inorganic phosphate was very low [0.35 mg/100 ml]. Intravenous potassium phosphate supplements returned serum phosphate levels to normal with reversal of the neurological manifistations. No hypophosphatemia was detected in the group of patients receiving fat emulsions