Pathophysiology, treatment, and prevention of fluid and electrolyte abnormalities during refeeding syndrome.
Refeeding syndrome may occur after the reintroduction of carbohydrates in chronically malnourished or acutely hypermetabolic patients as a result of a rapid shift to glucose utilization as an energy source. Electrolyte abnormalities of phosphorus, potassium, and magnesium occur, leading to complications of various organ systems, and may result in death. Patients should be screened for risk factors of malnutrition to prevent refeeding syndrome. For those at risk, nutrition should be initiated and slowly advanced toward the patient's goal over several days. Electrolyte disturbances should be aggressively corrected.
Department of Pharmacy Services, UK HealthCare, Lexington, Kentucky (Drs Parli and Magnuson); and Department of Pharmacy Services, Jewish Hospital KentuckyOne Health, Louisville, Kentucky (Dr Ruf). Sara E. Parli, PharmD, is a critical care clinical pharmacist at UK HealthCare. She works primarily with the acute general surgery/trauma team to provide comprehensive pharmaceutical care to patients, including intravenous therapy. She also provides adjunct assistance to the nutrition support service. Kathryn M. Ruf, PharmD, BCPS, is the critical care specialist at Jewish Hospital in Louisville, Kentucky. She has a special interest in nutrition support therapies and has recently completed research focusing on refeeding syndrome in a heterogeneous intensive care unit population. Barbara Magnuson, PharmD, BCNSP, is the coordinator and clinical pharmacist on a multidisciplinary nutrition support service at UK HealthCare that promotes the maintenance or restoration of optimal nutritional therapy for patients, primarily in critical care areas, receiving parenteral and/or enteral nutrition.
Sara E
SE
Parli
Kathryn M
KM
Ruf
Barbara
B
Magnuson
D004573:Electrolytes / Q000008:administration & dosage / Q000097:blood*; D006801:Humans; D055677:Refeeding Syndrome / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D012307:Risk Factors; D013217:Starvation / Q000503:physiopathology / Q000628:therapy*
D004573:Electrolytes