Changes of serum phosphorus level during continuous blood purification therapy in critically ill children / 中华实用儿科临床杂志

ABSTRACT

Objective To observe the changes of serum phosphorus level in critically ill children during con-tinuous blood purification therapy(CRRT)in order to improve the monitoring of serum phosphorus and guide the sup-plementation of phosphorus during CRRT in critically ill children.Methods The patients who received CRRT from January to June 2017 in Pediatric Intensive Care Unit of Beijing Children's Hospital Affiliated to Capital Medical Uni-versity were selected as subjects.The changes of serum phosphorus before and 24 h,48 h,72 h after treatment of CRRT in the patients were observed and recorded respectively.Results Thirty-two patients were enrolled in this study.The serum phosphorus were(0. 91 ± 0. 50)mmol/L,(0. 54 ± 0. 20)mmol/L,(0. 39 ± 0. 18)mmol/L,(0. 36 ± 0.19)mmol/L before and 24 h,48 h,72 h after treatment of CRRT.There were significant differences of serum phos-phorus in the critically ill children before and after CRRT(t=3.310,4.602,4.399,all P<0.01).All patients were accompanied with hypophosphatemia after 24 h treatment,and the absolute values of serum phosphorus reduction(△P) were(0.40 ± 0.39)mmol/L,(0.15 ± 0.05)mmol/L,(0.09 ± 0.02)mmol/L in every 24 hours during CRRT.The first 24 h was the fastest changing phase for serum phosphorus,and the differences of △P between the 24 h and the 48 h,the 72 h after CRRT were statistically significant respectively(t=2.598,3.278,all P<0.05).The serum phos-phorus was sharply decreased in the 24 h of CRRT in patients with normal serum phosphorus before CRRT,and the differences were statistically significant(all P<0.01);but this phenomenon was not seen in hypophosphatemia group (all P>0.05).Conclusion In the process of CRRT,the change of serum phosphorous may be dose-dependent and closely related to the treatment phase of CRRT.So a titration of phosphorus supplementation as a nutritional support strategy should be considered.