Late phosphorus supplementation is associated with severe hypophosphatemia in extremely low birth weight infants with early amino acid administration
Late phosphorus supplementation is associated with severe hypophosphatemia in extremely low birth weight infants with early amino acid administration
(구연):
Release Date : 2017. 10. 27(금)
Sae Mi Yang1, O Kyu Noh2,3, Jang Hoon Lee1, Moon Sung Park1, In Chan Hwang1 , Mi Jin Lee1
Ajou University Hospital Department of pediatrics1
Ajou University Hospital Department of Radiation and Oncology 2
Ajou University Hospital Department of Biomedical Informatics 3
양새미1, 노오규2,3, 이장훈1, 박문성1, 황인찬1 , 이미진1
아주대학교병원 소아청소년과1
아주대학교병원 방사선종양학과2
아주대학교병원 생명의료정보학3
Abstract
Objective: To investigate the incidence of severe hypophosphatemia, and examine the associated clinical factors and outcomes, in extremely low birth weight infants (ELBWI) who received early amino acid administration.
Study Design: Medical records of 82 ELBWI were retrospectively reviewed. Severe hypophosphatemia was defined as a serum phosphate level 2 mg/dL during the first week after birth.
Results: Nineteen ELBWI (23.2%) experienced severe hypophosphatemia. The supplementation of phosphorus was started significantly later in the Hypophosphatemia group compared to that in the Control group ( P = 0.036). Small for gestational age infants (SGAI) ( P = 0.006) and bronchopulmonary dysplasia (BPD) ( P = 0.001) were more prevalent in the Hypophosphatemia group compared to that in the Control group.
Conclusions: Severe hypophosphatemia is common in ELBWI. Late supplementation of phosphorus and SGAI were associated with severe hypophosphatemia. In addition, severe hypophosphatemia may be a predictive factor of BPD.
Keywords: Extremely low birth weight infants, Hypophosphatemia, Bronchopulmonary dysplasia
|
|
Control Group
(N=63)
|
Hypophosphatemia group (N=19)
|
P-value
|
|
PDA ligation
|
47.6% (30/63)
|
57.9% (11/19)
|
0.601
|
|
IVH ( Grade III)
|
18.0% (11/63)
|
36.9% (7/19)
|
0.475
|
|
Sepsis
|
34.9% (22/63)
|
57.9% (11/19)
|
0.128
|
|
EUGR
|
28.6% (18/63)
|
36.8% (7/19)
|
0.688
|
|
Sepsis
|
34.9% (22/63)
|
57.9% (11/19)
|
0.128
|
|
NEC (stage IIa)
|
12.7% (8/63)
|
21.1% (4/19)
|
0.594
|
|
Duration of TPN, (days)
|
37 [26; 53]
|
37 [17.5; 60.5]
|
0.899
|
|
ROP (Stage I)
|
38.1% (24/63 )
|
36.8% (5/19)
|
0.489
|
|
BPD (moderate)
|
56.4% (39/63)
|
100% (19/19)
|
0.001
|
|
Duration of mechanical ventilation (Days)
|
15 [6; 42.5]
|
20 [9; 62]
|
0.361
|
|
Mortality
|
17.5% (11/63)
|
42.1% (8/19)
|
0.055
|
Clinical outcomes in the neonatal intensive care unitAbbreviations: PDA, Patent duct arteriosus; IVH, intraventricular hemorrhage; EUGR, extrauterine growth retardation; NEC, necrotizing enterocolitis; TPN, total parenteral nutrition; ROP, retinopathy of prematurity; BPD, bronchopulmonary dysplasia
