Fructose-1,6-diphosphate/Glucose-1-phosphate

The importance of hypophosphataemia, its pathophysiology and management in the ICU is currently attracting a great deal of clinical interest. Organic phosphates such as d-Fructose-1, 6-diphosphate and Glucose-1-phosphate have been shown to have advantages over their inorganic counterparts for correcting severe hypophosphataemia (in septicaemia together with beneficial haemodynamic effects). Moreover, the pharmaceutical attraction of improved compatibility with calcium salts potentially offers other advantages to the compounding pharmacist, especially with paediatrics.                                   

Concerns over the aluminium contamination of phosphate and calcium additives used in TPN have been heightened by the new FDA limits recently published for LVPs.

However, our laboratory investigations using Inductively Coupled Plasma Atomic Emission Spectroscopy (recently presented at ESPEN) have further demonstrated the low aluminium levels in organic phosphates thus helping to improve our confidence in their clinical use.