Refeeding hypophosphataemia in a Malaysian intensive care unit: incidence, risk factors and outcomes

Introduction: Refeeding syndrome is characterised by acute electrolyte derangement following the start of nutrition. Hypophosphataemia is the predominant feature of the electrolyte derangement, hence commonly used for its definition. We aim to assess the incidence of refeeding hypophosphataemia, and...

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Main Authors:	Md Ralib, Azrina, Mat Nor, Mohd Basri, Ismail, Che Ainun Nasihah, Hassan, Muhammad Zul Hilmi, Tuan Ibrahim, Tuan Muhd Fahmi
Format:	Article
Language:	English English
Published:	Ministry of Health and Universiti Brunei Darussalem 2015
Subjects:	R Medicine (General)
Online Access:	http://irep.iium.edu.my/43768/ http://irep.iium.edu.my/43768/ http://irep.iium.edu.my/43768/1/BIMJ201511265.pdf http://irep.iium.edu.my/43768/4/43768_Refeeding%20hypophosphataemia%20in%20a%20Malaysian_SCOPUS.pdf

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spelling	iium-437682017-11-08T09:15:17Z http://irep.iium.edu.my/43768/ Refeeding hypophosphataemia in a Malaysian intensive care unit: incidence, risk factors and outcomes Md Ralib, Azrina Mat Nor, Mohd Basri Ismail, Che Ainun Nasihah Hassan, Muhammad Zul Hilmi Tuan Ibrahim, Tuan Muhd Fahmi R Medicine (General) Introduction: Refeeding syndrome is characterised by acute electrolyte derangement following the start of nutrition. Hypophosphataemia is the predominant feature of the electrolyte derangement, hence commonly used for its definition. We aim to assess the incidence of refeeding hypophosphataemia, and its associated risk factors, and outcome in our local ICU. Materials and Methods: This was a single centre, prospective observational study at the ICU of Hospital Tengku Ampuan Afzan Kuantan, involving adult admission longer than 48 hours. Chronic renal failure patients and those receiving dialysis were excluded. Refeeding hypophosphataemia (RH) was considered if plasma phosphate was less than 0.65 mmol/l. Results: Fifty-four patients were screened. After exclusion, 29 were recruited, of which, 13 (44.8%) patients had RH. Of this, 66% occurred with duration of fasting of less than two days. These patients had higher NUTRIC score (3.9 ± 2.1 versus 2.4 ± 1.9, p=0.05). There was a trend of lower albumin, magnesium, calcium and potassium concentration, however these were not statistically significant. All patients with hypomagnesaemia (less than 0.5 mmol/l) had RH (p=0.01). There were no differences in mortality, length of hospital or ICU stay and duration of mechanical ventilation. Conclusion: Refeeding hypophosphataemia is common, occurring in 45% of ICU admission regardless of their fasting status. Higher NUTRIC score and hypomagnesaemia were the risk factors, however we showed no differences in outcome. Future larger studies could evaluate the association between its risk factors and outcome in our local population. Ministry of Health and Universiti Brunei Darussalem 2015 Article PeerReviewed application/pdf en http://irep.iium.edu.my/43768/1/BIMJ201511265.pdf application/pdf en http://irep.iium.edu.my/43768/4/43768_Refeeding%20hypophosphataemia%20in%20a%20Malaysian_SCOPUS.pdf Md Ralib, Azrina and Mat Nor, Mohd Basri and Ismail, Che Ainun Nasihah and Hassan, Muhammad Zul Hilmi and Tuan Ibrahim, Tuan Muhd Fahmi (2015) Refeeding hypophosphataemia in a Malaysian intensive care unit: incidence, risk factors and outcomes. Brunei International Medical Journal, 11 (2). pp. 65-73. ISSN 2079-3146 (O), 1560-5876 (P) http://www.bimjonline.com/
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Md Ralib, Azrina Mat Nor, Mohd Basri Ismail, Che Ainun Nasihah Hassan, Muhammad Zul Hilmi Tuan Ibrahim, Tuan Muhd Fahmi Refeeding hypophosphataemia in a Malaysian intensive care unit: incidence, risk factors and outcomes
description	Introduction: Refeeding syndrome is characterised by acute electrolyte derangement following the start of nutrition. Hypophosphataemia is the predominant feature of the electrolyte derangement, hence commonly used for its definition. We aim to assess the incidence of refeeding hypophosphataemia, and its associated risk factors, and outcome in our local ICU. Materials and Methods: This was a single centre, prospective observational study at the ICU of Hospital Tengku Ampuan Afzan Kuantan, involving adult admission longer than 48 hours. Chronic renal failure patients and those receiving dialysis were excluded. Refeeding hypophosphataemia (RH) was considered if plasma phosphate was less than 0.65 mmol/l. Results: Fifty-four patients were screened. After exclusion, 29 were recruited, of which, 13 (44.8%) patients had RH. Of this, 66% occurred with duration of fasting of less than two days. These patients had higher NUTRIC score (3.9 ± 2.1 versus 2.4 ± 1.9, p=0.05). There was a trend of lower albumin, magnesium, calcium and potassium concentration, however these were not statistically significant. All patients with hypomagnesaemia (less than 0.5 mmol/l) had RH (p=0.01). There were no differences in mortality, length of hospital or ICU stay and duration of mechanical ventilation. Conclusion: Refeeding hypophosphataemia is common, occurring in 45% of ICU admission regardless of their fasting status. Higher NUTRIC score and hypomagnesaemia were the risk factors, however we showed no differences in outcome. Future larger studies could evaluate the association between its risk factors and outcome in our local population.
format	Article
author	Md Ralib, Azrina Mat Nor, Mohd Basri Ismail, Che Ainun Nasihah Hassan, Muhammad Zul Hilmi Tuan Ibrahim, Tuan Muhd Fahmi
author_facet	Md Ralib, Azrina Mat Nor, Mohd Basri Ismail, Che Ainun Nasihah Hassan, Muhammad Zul Hilmi Tuan Ibrahim, Tuan Muhd Fahmi
author_sort	Md Ralib, Azrina
title	Refeeding hypophosphataemia in a Malaysian intensive care unit: incidence, risk factors and outcomes
title_short	Refeeding hypophosphataemia in a Malaysian intensive care unit: incidence, risk factors and outcomes
title_full	Refeeding hypophosphataemia in a Malaysian intensive care unit: incidence, risk factors and outcomes
title_fullStr	Refeeding hypophosphataemia in a Malaysian intensive care unit: incidence, risk factors and outcomes
title_full_unstemmed	Refeeding hypophosphataemia in a Malaysian intensive care unit: incidence, risk factors and outcomes
title_sort	refeeding hypophosphataemia in a malaysian intensive care unit: incidence, risk factors and outcomes
publisher	Ministry of Health and Universiti Brunei Darussalem
publishDate	2015
url	http://irep.iium.edu.my/43768/ http://irep.iium.edu.my/43768/ http://irep.iium.edu.my/43768/1/BIMJ201511265.pdf http://irep.iium.edu.my/43768/4/43768_Refeeding%20hypophosphataemia%20in%20a%20Malaysian_SCOPUS.pdf
first_indexed	2023-09-18T21:02:19Z
last_indexed	2023-09-18T21:02:19Z
_version_	1777410705089101824

Refeeding hypophosphataemia in a Malaysian intensive care unit: incidence, risk factors and outcomes

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