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3.11.6 - Phosphate
from Section 3.11 - Metabolic Disorders
- By Clare Morkane
Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
Book:

Intensive Care Medicine

Published online:

27 July 2023

Print publication:

01 December 2021, pp 375-375
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Summary

Key Learning Points
1. Phosphate and calcium are intimately related; both are under tight physiological control.
2. Phosphate plays a critical role in a number of processes, including energy metabolism, cellular signalling, bone mineralisation and membrane integrity.
3. Hypophosphataemia is a commonly encountered electrolyte abnormality in critically ill patients.
4. Disturbances in phosphate level are often multifactorial in aetiology.
5. Hypophosphataemia can result in respiratory failure and difficulty weaning from mechanical ventilation.

Chapter 29 - Failure of oxygenation
from Section III: - Organ dysfunction and management
- By Darshan Pandit, Joyce Yeung
Edited by Fang Gao Smith, University of Warwick
Edited in association with Joyce Yeung
Book:

Core Topics in Critical Care Medicine

Published online:

06 July 2010

Print publication:

22 April 2010, pp 232-240
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Summary

Fluid and electrolyte balance is an important everyday practice on the intensive care unit. The different types of fluids are crystalloids that include Hartmann's solution, normal (isotonic) saline, dextrose, and colloids that include albumin, starch and gelatins. The disorders of sodium concentration are nearly always caused by excess free water (hyponatraemia) or free water loss (hypernatraemia). The potassium balance is affected by hypokalaemia and hyperkalaemia. The abnormalities in magnesium are caused by hypomagnesaemia and hypermagnesaemia. The abnormalities in phosphorous are caused by hypophosphataemia and hyperphosphataemia. The abnormalities in calcium are caused by hypocalcaemia and hypercalcaemia. Hypercalcaemia is not a common problem in intensive care. In 90% of cases, the underlying cause is hyper-parathyroidism or malignancy. Treatment is indicated when the hypercalcaemia is associated with adverse effects, or when the serum calcium is greater than 14 mg/dl (ionized calcium above 3.5 mmol/l).

Serum phosphate in older people
Part of
- Bespoke shallow archive Weizmann
M Lambert, MD Witham, D Sumukadas
Journal:

Reviews in Clinical Gerontology / Volume 19 / Issue 4 / November 2009

Published online by Cambridge University Press:

21 December 2009, pp. 263-270

Print publication:

November 2009
- Article
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Phosphate (PO4−) has a number of important functions in the human body and abnormalities of phosphate handling and phosphate levels are common in older people. We review the physiological functions of phosphate, the effects of phosphate deficiency and excess, and discuss the evidence underpinning management of these conditions in older people. Both hyper- and hypophosphataemia have been associated with a variety of adverse effects in different patient groups. There is currently little evidence to guide practice in treatment of abnormal phosphate levels specifically in older people. Studies looking into the effect of replacing phosphate on morbidity and mortality in milder cases of hypophosphataemia and into the dangers of, and treatment of, hyperphosphataemia in older people are required.