EFFECTS OF HYPOPHOSPHATEMIA IN PEDIATRIC CARDIAC SURGERY

IntroductionHypophosphatemia is common in ICU patients especially undergoing cardiac surgery with extracorporeal circulation (1). Phosphate disturbance has been reported to be associated with increased morbidity and mortality in critically ill patients such as respiratory failure, increase the duration of stay on mechanical ventilation, and increased PICU length of stay (2). In our study, it was eveluated pre and postoperatively phosphorus levels for establish association of phosphate levels with ssurgical outcome of pediatric patients with cardiac disease.MethodsWe prospectively measured Phosphorus levels (preoperative, at the pediatric intensive care unit arrival, and at 24) in 85 children undergoing cardiac surgery.Patients were divided in two groups according to immediate postoperative Phosphate levels; those with hypophosphatemia (<3,7) and other group with normal Phosphate levels (3,7-6,5) Aortic cross clamp time (ACC time), cardiopulmonary bypass time (CPB time), inotropic score, duration of ventilation, PICU stay and mortality were recorded.ResultsACC,CPB times and inotropic score were higher in hypophosphatemia group than normal phosphate group (respectively, p=0,02, p=0,03, p=0,01) . However, duration of ventilation and ICU stay were longer in hypophosphatemia group than normal phosphate group (respectively, p=0,002, p=0,001). No significant difference of post operative mortality was found in both groups (p=0,07).DiscussionHypophosphatemia was common after pediatric cardiac surgery. However, hypophosphatemia may ocur in postoperative period especially, intraoperative management and is associated with significant respiratory and cardiac morbidity. So, serum Phosphorus levels should be routinely measured after cardiac surgery and appropriate therapy may be started.