Serum Phosphate and 2,3-Diphosphoglycerate in Severely Burned Patients after Phosphate Supplementation

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Abstract
Serum phosphate (S-P) and 2,3-diphosphoglycerate (2,3-DPG) were monitored for 10 days after severe burn trauma in 16 patients treated with total parenteral nutrition, including supplementation with 25—75 mmol phosphate daily. Phosphate metabolism was previously shown to be disturbed in patients with severe burns, and hypophosphatemia has been reported to disturb oxygen transport by reducing synthesis of 2,3-DPG in the red cells. In this study, S-P was decreased in the first post-trauma week because of a negative phosphate balance the first 4 post-trauma days, but 2,3-DPG remained at normal concentrations. These findings indicate that posttraumatic disturbance in red-cell phosphate metabolism may be prevented by administration of phosphate and that such supplementation is important in the metabolic management of severely injured patients.