title: [Quality management in weight restitution in Anorexia nervosa--pathophysiology, evidence-based practice and prevention of the refeeding syndrome].
abstract: During refeeding syndrome-a well-known and dreaded complication of weight-restauration in anorexia nervosa-a shift of electrolytes and fluid can occur in malnourished patients and might therefore lead to-potentially fatal-cardiovascular, respiratory and neurological symptoms. Causes of this are metabolic and hormonal changes during re-establishment of a carbohydrate-rich diet. This syndrome is most commonly associated with hypophosphatemia, which can however be accompanied by other chemical laboratory abnormalities. Standardized guidelines for the prevention and management of the refeeding syndrome have not yet been established. In case and cohort studies different low- and high-calorie diet protocols led to comparable results with similar complication rates. A focus should be placed on prevention of serious complications by careful monitoring. The pathophysiology, the main constituents in the development of the refeeding syndrome, recommendations for risk assessment and treatment, and current evidence are discussed.
authors.affiliation: Eating Disorders Unit, Universitätsklinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich. n0702737@students.meduniwien.ac.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Mayr
authors.affiliation: Kompetenzzentrum für Essstörungen und Adipositas, Parklandklinik, Bad Wildungen, Deutschland. hartmut.imgart@parkland-klinik.de.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Imgart
authors.affiliation: Eating Disorders Unit, Universitätsklinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
authors.forename: Katrin
authors.initials: K
authors.lastname: Skala
authors.affiliation: Eating Disorders Unit, Universitätsklinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich. andreas.karwautz@meduniwien.ac.at.
authors.forename: Andreas
authors.initials: A
authors.lastname: Karwautz
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000503:physiopathology* / Q000523:psychology* / Q000628:therapy*; D002149:Energy Intake / Q000502:physiology; D055317:Evidence-Based Practice; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D055677:Refeeding Syndrome / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology; D018570:Risk Assessment; D017749:Total Quality Management; D014882:Water-Electrolyte Balance / Q000502:physiology; D015430:Weight Gain
keywords: Adolescence; Anorexia nervosa; Evidence based practice; Guidelines; Pathophysiology; Refeeding syndrome