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Biochemical effects of phosphate-containing replacement fluid for continuous venovenous hemofiltration

Version 2 2024-06-03, 23:31
Version 1 2022-11-01, 05:05
journal contribution
posted on 2024-06-03, 23:31 authored by HR Chua, Ian BaldwinIan Baldwin, L Ho, A Collins, H Allsep, R Bellomo
Aims: To examine biochemical effects of phosphate-containing replacement fluid (Phoxilium®) for continuous venovenous hemofiltration (CVVH). Methods: Retrospective comparison of respective serum biochemistry with sequential use of Accusol™ and Phoxilium, each over 48 h of CVVH. Results: We studied 15 critically ill patients. Accusol was switched to Phoxilium after 5 (4–8) days of CVVH. Respective serum biochemistry after 36–42 h of Accusol versus Phoxilium were: phosphate 1.02 (0.82–1.15) versus 1.44 (1.23–1.78) mmol/l, ionized calcium 1.28 (1.22–1.32) versus 1.12 (1.06–1.21) mmol/l, bicarbonate 24 (23–25) versus 20 (19–22) mmol/l, base excess 0 (–2 to 1) versus –4 (–6 to –3) mmol/l (p < 0.001). Cumulative phosphate intakes during respective periods were 69.6 (56.6–76.6) versus 67.2 (46.6–79.0) mmol (p = 0.45). Plasma strong ion differences were narrower with Phoxilium (p < 0.05), with similar strong ion gaps. No additional intravenous phosphate was given during Phoxilium use. Seven patients had serum phosphate >1.44 mmol/l. Conclusions: Phoxilium versus Accusol use during CVVH effectively prevented hypophosphatemia but contributed to mild hyperphosphatemia, and is associated with relative hypocalcemia and metabolic acidosis.

History

Journal

Blood Purification

Volume

34

Pagination

306-312

Location

Switzerland

ISSN

0253-5068

eISSN

1421-9735

Language

en

Publication classification

C1.1 Refereed article in a scholarly journal

Issue

3-4

Publisher

S. Karger AG