Hypophosphatemia-associated respiratory muscle weakness in a general inpatient population

Abstract

Although hypophosphatemia has been implicated as a cause of respiratory failure, its impact on respiratory muscle function in patients hospitalized for other reasons remains to be determined. Maximal inspiratory pressures (MIP) and maximal expiratory pressures (MEP) were measured at the bedside in 23 hospitalized patients with serum phosphate levels less than 2.5 mg/dl, and these measurements were repeated daily during phosphate repletion until serum phosphate levels reached the normal range. A control group consisted of 11 normophosphatemic inpatients. Sixteen of 23 hypophosphatemic patients, but none of the control patients (p 2O or a MEP less than 70 cm H2O. The mean initial MIP and MEP values were also significantly lower for the hypophosphatemic group. A significant correlation existed between initial phosphate level and initial MIP value (r = 0.50, p 2O to -49 +/- 24 cm H2O (p 2O to 69 +/- 19 cm H2O (p <0.02). It is concluded that respiratory muscle weakness is common among hypophosphatemic patients and improves with phosphate repletion.