A patient with severe burns may have significant hypophosphatemia. Phosphate depletion can have a negative effect on energy production.

The incidence of any degree hypophosphatemia increases with the percent body surface area burned and with the time in hospital if untreated. Patients who recover will show a return to normal plasma concentrations. Patients who do not recover may show low and/or declining plasma concentrations.


Yang et al found moderate (1 to 2 mg/dL) or severe hypophosphatemia (< 1 mg/dL) in two thirds of burn patients. However, it was not an independent predictor of mortality.


Features of hypophosphatemia in burn patients:

(1) reduced serum inorganic phosphorus concentration

(2) reduced urine concentration of inorganic phosphorus


If the patient becomes septic then severe hypophosphatemia may be associated with a worse prognosis.


If significant hypophosphatemia is identified then replacement therapy should be started.

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