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Nutrition in clinical practice-the refeeding syndrome: illustrative cases and guidelines for prevention and treatment.
Stanga, Z; Brunner, A; Leuenberger, M; Grimble, R F; Shenkin, A; Allison, S P; Lobo, D N.
Afiliación
  • Stanga Z; Department of Internal Medicine, University Hospital, Bern, Switzerland.
Eur J Clin Nutr ; 62(6): 687-94, 2008 Jun.
Article en En | MEDLINE | ID: mdl-17700652
The refeeding syndrome is a potentially lethal complication of refeeding in patients who are severely malnourished from whatever cause. Too rapid refeeding, particularly with carbohydrate may precipitate a number of metabolic and pathophysiological complications, which may adversely affect the cardiac, respiratory, haematological, hepatic and neuromuscular systems leading to clinical complications and even death. We aimed to review the development of the refeeding syndrome in a variety of situations and, from this and the literature, devise guidelines to prevent and treat the condition. We report seven cases illustrating different aspects of the refeeding syndrome and the measures used to treat it. The specific complications encountered, their physiological mechanisms, identification of patients at risk, and prevention and treatment are discussed. Each case developed one or more of the features of the refeeding syndrome including deficiencies and low plasma levels of potassium, phosphate, magnesium and thiamine combined with salt and water retention. These responded to specific interventions. In most cases, these abnormalities could have been anticipated and prevented. The main features of the refeeding syndrome are described with a protocol to anticipate, prevent and treat the condition in adults.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Equilibrio Hidroelectrolítico / Apoyo Nutricional / Desnutrición Tipo de estudio: Etiology_studies / Guideline / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Humans Idioma: En Revista: Eur J Clin Nutr Asunto de la revista: CIENCIAS DA NUTRICAO Año: 2008 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Equilibrio Hidroelectrolítico / Apoyo Nutricional / Desnutrición Tipo de estudio: Etiology_studies / Guideline / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Humans Idioma: En Revista: Eur J Clin Nutr Asunto de la revista: CIENCIAS DA NUTRICAO Año: 2008 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido