No difference in mechanical ventilation–free hours in critically ill patients who received intravenous, oral, or enteral phosphate replacement

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To determine the impact on duration of mechanical ventilation (MV) and the need for reintubation after changing from intravenous (IV) to oral phosphate formulations, in response to a national shortage of IV phosphate.


A retrospective study was performed in adult patients who required MV for at least 48 hours.


A total of 136 patients were included, with 68 patients in both the restricted phosphate group and unrestricted phosphate groups. There was no difference in the cumulative phosphate supplementation received (IV and oral) between groups (P = .08). The overall mean serum phosphorus concentration in unrestricted vs restricted group was 3.0 vs 2.9 mg/dL, respectively (P = .24), and the phosphorus concentration was not significantly different between groups during the first 21 days of the study (P = .24). The median MV-free hours in the unrestricted group was 462 hours compared with 507 hours in the restricted group (P = .16), and 9 (13.2%) of patients in each group required reintubation (P = .99). There was no significant difference in mortality, or hospital, or intensive care unit (ICU) length of stay.


No difference in MV-free hours or need for reintubation was observed after a national shortage requiring the restriction of IV phosphate supplementation. Oral phosphate replacement is a safe and an efficient alternative.

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