Phosphate is the forgotten electrolyte of critical care. Unlike other electrolytes, phosphate doesn't participate in the generation of electrochemical gradients (like calcium, magnesium, and potassium) or govern tonicity (like sodium). Thus, moderate perturbations in phosphate are generally asymptomatic. However, phosphate does participate in many essential cellular processes, so true intracellular hyphophosphatemia can cause severe symptoms. This pair of chapters provide algorithms for the management of hypophosphatemia and hyperphosphatemia, so if you check the phosphate level and follow these you should be fine.
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The IBCC chapter on HYPOphosphatemia is located here.
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The IBCC chapter on HYPERphosphatemia is located here.
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- PulmCrit hot take: VAP prophylaxis (PROPHY-VAP trial) - January 22, 2024