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Research Article

JCDR. 2021; 12(5): 462-475

Risk Factors For Development Of Refeeding Syndrome- Like Hypophosphatemia In Critically Ill Children In Zagazig University Hospitals

Dina Gamal Abdel Mohsen,NahedKhater, Dalia A. Rahman, andAbeer Abd Alla.


Background: Hypophosphatemia is a metabolic disturbance with potentially serious complications and
is often unrecognized in critically ill children. Symptoms of hypophosphatemia are unspecific in the
majority of cases and include fatigue and irritability, severe hypophosphatemia (less than 1.0 mg/dl)
may lead to more serious problemssuch as reduced diaphragmatic contractility and cardiac arrhythmias.
Aim of the Study: Estimate the incidence of hypophosphatemia in critically ill children, study its
clinical effects and risk factors in patients during their stay in PICU.
Patients and Methods:A case-control study that was conducted over a period of one year, from June
2018 to May 2019, at PICU of Pediatrics Department, Zagazig University Hospitals.The study included
180 subjects that were classified into two groups, each of 90 subjects as follows;patients group, which
included 90 cases,and the control group, which included 90 healthy infants and children.
Results:There was a statistically significant difference between the studied groups regarding weight,
height percentile, ESR and CRP, hemoglobin level, TLC, PT, INR, alkaline phosphatase a serum,
serum creatinine, PH, serum phosphorus level, presence of hypophosphatemia as 20% had
hypophosphatemia, number of patients with hypophosphatemia, percent change in serum phosphorus,
percent change in serum potassium, degree of hypophosphatemia and either duration of hospital stays
and duration of MV.
Conclusion: The apparent acceptable cause of hypophosphatemia in our study is delayed TPN decision
and sepsis. Mild to moderate hypophosphatemia developed in PICU. Hypophosphatemia was associated
with prolongation of the duration of PICU stay and bad outcomes.

Key words: Hypophosphatemia; Critical Ill children; Risk factors.

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