Refeeding Syndrome Flashcards
What is refeeding syndrome?
It is defined as a condition in which rapid reintroduction of normal nutrition in chronically malnourished individuals leads to metabolic abnormalities
What is the pathophysiology of refeeding syndrome?
In chronic malnutrition, intracellular stores of electrolytes become depleted
Therefore, when individuals are suddenly provided with normal levels of nutrition, there is a sudden shift of these electrolytes from the extracellular to the intracellular compartment
This can ultimately lead to a sudden drop in extracellular levels of key electrolytes
What are the four high risk factors associated with refeeding syndrome?
BMI < 16kg/m2
Weight Loss > 15%, 3 – 6 Months
Minimal Nutritional Intake > 10 Days
Hypophosphatemia, Hypokalaemia or Hypomagnesemia Prior To Feeding
What are the four moderate risk factors associated with refeeding syndrome?
BMI < 18.5kg/m2
Weigh Loss > 10%, 3 – 6 Months
Minimal Nutritional Intake > 5 Days
Alcohol Abuse OR Drug Administration of Insulin, Chemotherapy, Diuretics or Antacids
What are the seven clincial features of refeeding syndrome?
Confusion
Dyspnoea
Muscle Weakness
Oedema
Arrythmias
Seizures
Hypertension
What are the two investigations used to diagnose refeeding syndrome?
Blood Tests
ECG Scan
What are the three blood test results indicative of refeeding syndrome?
Decreased Phosphate Levels
Decreased Potassium Levels
Decreased Magnesium Levels
What ECG scan feature indicates refeeding syndrome?
Torsades de pointes
When is preventative management of refeeding syndrome recommended?
In cases where individuals present with one high risk factor or two moderate risk factors
What are the two preventative management options of refeeding syndrome?
We gradually reintroduce their nutrition under the guidance of a dietician
In addition, urea and electrolyte monitoring is conducted regularly in order to allow early identification of metabolic abnormalities, with appropriate replacement
