Refeeding syndrome.
Refeeding syndrome (RFS) is the result of aggressive enteral or parenteral feeding in a malnourished patient, with hypophosphatemia being the hallmark of this phenomenon. Other metabolic abnormalities, such as hypokalemia and hypomagnesemia, may also occur, along with sodium and fluid retention. The metabolic changes that occur in RFS can be severe enough to cause cardiorespiratory failure and death. This article reviews the pathophysiology, the clinical manifestations, and the management of RFS. The key to prevention is identifying patients at risk and being aware of the potential complications involved in rapidly reintroducing feeds to a malnourished patient.
Fuentebella
Judy
J
Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Lucile Packard Children's Hospital, Stanford University Medical Center, 750 Welch Road, Suite 116, Palo Alto, CA 94304, USA. judyf@stanford.edu
Kerner
John A
JA
D002648:Child; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000503:physiopathology; D006955:Hypernatremia / Q000209:etiology / Q000503:physiopathology; D007008:Hypokalemia / Q000209:etiology / Q000503:physiopathology; D017674:Hypophosphatemia / Q000209:etiology / Q000503:physiopathology; D015994:Incidence; D008275:Magnesium Deficiency / Q000209:etiology / Q000503:physiopathology; D044342:Malnutrition / Q000178:diet therapy* / Q000378:metabolism / Q000503:physiopathology*; D055677:Refeeding Syndrome / Q000150:complications / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D013217:Starvation / Q000178:diet therapy / Q000378:metabolism