Acute Phosphate Intoxication in Seven Infants Under Parenteral Nutrition

Acute Phosphate Intoxication in Seven Infants Under Parenteral Nutrition

After major surgery, seven infants aged 4 to 29 weeks, under parenteral nutrition, received monosodium phosphate (4.2 to 14.3 mEq/kg body weight) instead of prescribed calcium gluconate. The wrong solution was perfused during 16 hours. At the 15th hour, blood samples showed hyperphosphatemia in all...

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Bibliographic Details
Published in:JPEN. Journal of parenteral and enteral nutrition Vol. 16; no. 6; pp. 558 - 560
Main Authors: Biarent, D., Brumagne, C., Steppe, M., Bouton, J.-M.
Format: Journal Article
Language:English
Published: Thousand Oaks, CA Sage Publications 01-11-1992
SAGE Publications
ASPEN
Subjects:
Biological and medical sciences
Calcium Gluconate - administration & dosage
Drug intoxications. Doping
Humans
Infant
Infant, Newborn
Medical sciences
Medication Errors
Parenteral Nutrition
Pharmacology. Drug treatments
Phosphates - administration & dosage
Phosphates - poisoning
Human
Intravenous administration
Drug intoxication
Organic phosphate
Infant
Resuscitation
Parenteral administration
Feeding
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Summary:After major surgery, seven infants aged 4 to 29 weeks, under parenteral nutrition, received monosodium phosphate (4.2 to 14.3 mEq/kg body weight) instead of prescribed calcium gluconate. The wrong solution was perfused during 16 hours. At the 15th hour, blood samples showed hyperphosphatemia in all (8.0 to 14.4 mg/100 mL) and hypocalcemia in four infants (6.1 to 8.0 mg/100 mL), but all were asymptomatic. Under a perfusion of glucose in water, calcemia and phosphatemia returned to normal within 24 hours. In a review of the pediatric literature, we found 11 subjects with symptomatic acute phosphate intoxication, who also presented with hypocalcemia and hyperphosphatemia. The differences were that they received high bolus doses of phosphate orally or rectally and showed symptomatic features. Normalization of the calcemia occurred only when hyperphosphatemia was corrected throughout intravenous hydration. (Journal of Parenteral and Enteral Nutrition 16:558-560, 1992)
ISSN:0148-6071
1941-2444
DOI:10.1177/0148607192016006558