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Hidden dangers of the perioperative period: focus on hypophosphatemia

Hypophosphatemia (HPE) — one of the frequent electrolyte disorders, its development in the perioperative period has many causes. We analyzed the Medline database over the past 20 years to identify the articles with “hypophosphatemia” as one of the keywords. The search included clinical and experimental studies, reviews, and reports of clinical cases with English abstract. 1,754 publications were found. Based on the studied articles, we have summarized information about phosphate metabolism, the main clinical manifestations of HFE, the effect of HFE on the course of the perioperative period. The authors present their own experience in the detection and treatment of HFE. In general, the determination of phosphate levels was carried out in 328 patients who underwent surgical treatment in various surgical units. The highest rate of HFE was observed in burn patients (23.08 %), after neurosurgical (17.94 %) and abdominal (17.64 %) interventions. It was found that it is advisable to correct severe HFE by intravenous administration of sodium D-fructose-1,6-diphosphate — Esafosfina. After correction with this drug, the level of phosphatemia stabilized to the reference values, which coincided with the clinical improvement of patients. Patients in general well tolerated Esafosfina therapy, none of them had adverse effects.