Refeeding Syndrome - Diagnosis and Management
Electrolyte/fluid ...

Refeeding Syndrome - Diagnosis and Management

Electrolyte/fluid shifts caused by initiation of nutrition in severely malnourished patient, can be fatal

 • Risk Factors: poor/minimal intake for >7 days, significant weight loss, history of excessive alcohol intake, malnutrition due to chronic disease/malabsorptive conditions, anorexia nervosa, persistent N/V/D

 • Characterized by:

     o Early: hypo-Phos, hypo-K, hypo-Mg2+, vitamin deficiency (thiamine)

     o Late: cardiac damage (CHF), respiratory failure (volume overload)

     o Other symptoms: N/V, diarrhea, tremors, paresthesias

 • Prevention and management: Treat electrolyte abnormalities before refeeding, slow initial feeding, close monitoring of labs (Phos, K, Mg2+), Q8-Q12h and tele over first 24 hrs. Aggressive repletion of electrolytes (IV preferred). Replete thiamine prior to initiating feeding; stop feeding if electrolyte abnormalities persist.

#Refeeding #Syndrome #Diagnosis #Management
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