Is refeeding syndrome an emergency?

Refeeding is the process of reintroducing food after malnourishment or starvation. Refeeding syndrome is a serious and potentially fatal condition that can occur during refeeding. It’s caused by sudden shifts in the electrolytes that help your body metabolize food.

What is the most important electrolyte to monitor when refeeding the malnourished patient?

Plasma electrolytes, in particular sodium, potassium, phos- phate, and magnesium, should be monitored before and during refeeding, as should plasma glucose and urinary electrolytes.

How can you prevent refeeding syndrome at home?

“the risk of refeeding syndrome should be avoided through gradual increase of caloric intake and close monitoring of weight, vital signs, fluid shifts and serum electrolytes”. It, however, did not advise on how many calories to start, by how many calories to increase, nor how often to increase calories.

What foods prevent refeeding syndrome?

Doctors should refeed patients slowly, starting with 1,000 calories per day and increasing by 20 calories each day, to prevent refeeding syndrome. Administering oral vitamins and minerals such as phosphate, calcium, magnesium and potassium can also help prevent refeeding syndrome.

Is there a NICE guideline for refeeding syndrome?

In 2006 a guideline was published by the National Institute for Health and Clinical Excellence (NICE) in England and Wales. Yet because clinicians are often not aware of the problem, refeeding syndrome still occurs.1 This review aims to raise awareness of refeeding syndrome and discuss prevention and treatment.

What is the pathophysiology of refeeding syndrome?

Water follows by osmosis. These processes result in a decrease in the serum levels of phosphate, potassium, and magnesium, all of which are already depleted. The clinical features of the refeeding syndrome occur as a result of the functional deficits of these electrolytes and the rapid change in basal metabolic rate.

How often should electrolytes be checked for refeeding syndrome?

Electrolyte levels should be measured once daily for one week, and at least three times in the following week. Urinary electrolytes could also be checked to help assess body losses and to guide replacement. How can refeeding syndrome be detected and treated?

What supplements should be taken during refeeding?

All guidelines recommend that vitamin supplementation should be started immediately, before and for the first 10 days of refeeding. Circulatory volume should also be restored. Oral, enteral, or intravenous supplements of the potassium, phosphate, calcium, and magnesium should be given unless blood levels are high before refeeding.