Open AccessLife Threatening Rapid Onset of Hypophosphatemia Induced by Intravenous Iron Treatment Following Pulmonary Resection
Author(s) -
Eren Erdoğdu,
Fahmin Amirov,
Özlem Turhan,
Berker Özkan,
Zerrin Sungur,
Murat Kara
Publication year - 2020
Publication title -
göğüs kalp damar anestezi ve yoğun bakım derneği dergisi
Language(s) - English
Resource type - Journals
ISSN - 1305-5550
DOI - 10.5222/gkdad.2020.49092
Subject(s) - hypophosphatemia , medicine , parenteral nutrition , surgery , complication , intravenous iron , perioperative , anemia , anesthesia , iron deficiency
Severe hypophosphatemia is a rare electrolyte disturbance among surgical patients associated with severe fatigue, impaired cardiac and respiratory functions. Although mild hypophosphatemia is common after parenteral administration of intravenous iron replacement, severe hypophosphatemia is not usual in perioperative period. We present a case of 76-year-old female who underwent surgery for a left paramediastinal mass. Laboratory examination showed hypochromic microcytic anemia. A total dose of parenteral 1000 mg ferric carboxymaltose was administered two days prior to the operation with the aim of achieving a rapid increase in hemoglobin. We performed a wedge resection for the mass originating from the left upper lobe. The patient developed dyspnea and fatigue with severe hypophosphatemia on postoperative third day. The clinical status of the patient could be only improved with parenteral administration of high dose of sodium phosphate. We tried to emphasize this unexpected complication of intravenous iron replacement and the features of its management.