Pediatric anesthesia & critical care
Hypophosphatemia as a biomarker of metabolic intolerance to enhanced nutrition in the pediatric intensive care unit (PICU): a secondary analysis of the PEPaNIC RCT
Authors' conclusion
Development of hypophosphatemia may identify critically ill children who are particularly harmed by early-PN.
Study context
- Population
- Critically ill children in the PICU
- Participants
- 1,440 children
- Comparison
- Early-PN vs late-PN in children with vs without early hypophosphatemia
- Primary endpoint
- Incidence of new infections and duration of PICU dependency (interaction of hypophosphatemia with randomized intervention)
Methodological detailsadjusted for baseline risk factors, with and without imputation of missing phosphate data
- Adjusted for baseline risk factors
- With and without imputation of missing phosphate data
Primary result
As reported in the abstract
Interaction of hypophosphatemia with randomization · PICU day 1 and day 2
- Day 2 hypophosphatemia × randomization: risk of new infection (interaction P)
- P = 0.031
- Day 2 hypophosphatemia × randomization: likelihood of earlier live PICU discharge (interaction P)
- P = 0.030
Secondary outcomes
Hypophosphatemia incidence (patients with available phosphate) · Day 1 and day 2
- Day 1 hypophosphatemia
- 19.9% (211/1060)
- Day 2 hypophosphatemia
- 27.5% (243/883)
Time to live weaning from mechanical ventilation · Day 2
- Day 2 hypophosphatemia × randomization interaction P
- P = 0.025
90-day mortality (after imputing missing phosphate data)
- Interaction P; higher mortality with early-PN in hypophosphatemia
- P = 0.038
- Imputed analysis
Original publication
Hypophosphatemia as a biomarker of metabolic intolerance to enhanced nutrition in the PICU: a secondary analysis of the PEPaNIC RCT. Crit Care. Published 12 February 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →