Hypophosphatemia in a Patient with Severe Burns

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.