- Refeeding syndrome
Infobox_Disease
Name = PAGENAME
Caption =
DiseasesDB = 11205
ICD10 =
ICD9 =
ICDO =
OMIM =
MedlinePlus =
eMedicineSubj =
eMedicineTopic =
MeshID =Refeeding syndrome is a syndrome consisting of metabolic disturbances that occur as a result of reinstitution of nutrition to patients who are starved or severely malnourished. Renourishment is the process of avoiding refeeding syndrome. The syndrome was first described in Japanese war prisoners after the
Second World War .yndrome
Refeeding syndrome usually occurs within four days of starting to feed. Patients can develop fluid and
electrolyte disorders, especiallyhypophosphatemia , along with neurologic, pulmonary, cardiac, neuromuscular, and hematologic complications. Most effects result from a sudden shift from fat tocarbohydrate metabolism and a sudden increase ininsulin levels after refeeding which leads to increased cellular uptake ofphosphate . Refeeding increases thebasal metabolic rate . Intracellular movement of electrolytes occurs along with a fall in theserum electrolytes including phosphate,potassium ,magnesium ,glucose , andthiamine . Significant risks arising from refeeding syndrome include confusion,coma , convulsions, and death.This syndrome can occur at the beginning of treatment for
anorexia nervosa when patients are reintroduced to a healthy diet.The shifting of electrolytes and fluid balance increases cardiac workload and heart rate. This can lead to acute heart failure. Oxygen consumption is also increased which strains the respiratory system and can make weaning from ventilation more difficult.Treatment
Refeeding syndrome can be fatal if not recognized and treated properly. If potassium,phosphate or magnesium are low then this should be corrected. Prescribing thiamine, B Costrong and a multivitamin and mineral is recommended. Biochemistry should be monitored regularly until it is stable.
References
Shils, M.E., Shike, M., Ross, A.C., Caballero, B. & Cousins, R.J. (2006). Modern nutrition in health and disease, 10th ed. Lippincott, Williams & Wilkins. Baltimore, MD.Mahan, L.K. & Escott-Stump, S.E. (2004) Krause’s Food, Nutrition, & Diet Therapy, 11th ed. Saunders, Philadelphia, PA.
*
*
*
*
Wikimedia Foundation. 2010.