Refeeding syndrome: An overlooked condition?

Yuttiwat Vorakunthada MD, Passisd Laoveeravat MD, Wasawat Vutthikraivit MD, Weerapong Lilitwat MD, FAAP, Ariwan Rakvit MD, FACG

ABSTRACT

Refeeding syndrome (RFS) is commonly seen in different settings, particularly in the intensive care unit. However, it is not well recognized due to the lack of a standard definition. In general, hypophosphatemia is considered a diagnostic marker, but hypokalemia, hypomagnesemia, and shifts in thiamine and trace elements can also occur. Identification of high-risk patients is the key to prevention, especially in malnourished patients. Furthermore, introduction of oral, enteral, or parenteral nutrition in critically ill patients who have not received recent nutrition might lead to RFS. To date, there is no standard feeding protocol to prevent RFS. Therefore, awareness of RFS in high-risk patients, fluid and electrolyte treatment, and daily monitoring of clinical parameters are essential in the management of RFS.

Keywords: Refeeding syndrome, hypomagnesemia, hypokalemia, hypophosphatemia, malnourished patients, critically ill, nutrition


Article citation: Vorakunthada Y, Laoveeravat P, Vutthikraivit W, Lilitwat W, Rakvit A. Refeeding syndrome: an overlooked condition? The Southwest Respiratory and Critical Care Chronicles 2018;6(23):4–9
From: The Department of Internal Medicine at Texas Tech University Health Sciences Center in Lubbock, TX (YV, PL, WV, AR) and the Department of Pediatric Critical Care Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA (WL).
Submitted: 1/31/2018
Accepted: 3/29/2018
Reviewer: Scott O’Banion, Pharm D
Conflicts of interest: none
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.