Phosphorus/Hypophosphatemia in the Critically Ill: Let’s Correct it!

I covered this topic about hypophosphatemia in the critically ill back in the infancy of my Instagram account on 4/19/2019. Seems like an eternity ago. I know it’s not very Zentensivist of me to have this as part of my practice, but this is something I actively chase in my patients. Phosphorus, generally speaking, is not a component of the basic metabolic panel nor the complete metabolic panel. In the institutions I have worked at, at least, it is usually something you need to order on its own or part of the renal panel.

Do you check phosphorus levels in your critically ill patients? 
If so, how often? 

It’s not very #zentensivist of me and some may say it’s wasteful but I do routinely check phosphorus levels in my sick vented patients and those who have risk factors for hypophosphatemia. No, there are no large randomized controlled trials that show that replacing them causes a benefit. But it makes physiological sense when it’s so important for respiratory muscle function and has shown to have a correlation with failure to wean from mechanical ventilation.

Check out the podcast for additional details about hypophosphatemia in the critically ill

Check out my youtube video on this!


Geerse DA, Bindels AJ, Kuiper MA, Roos AN, Spronk PE, Schultz MJ. Treatment of hypophosphatemia in the intensive care unit: a review. Crit Care. 2010;14(4):R147. doi:10.1186/cc9215
Link to Abstract

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