refeeding syndrome


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refeeding

 [re-fēd´ing]
restoration of normal nutrition after a period of fasting or starvation.
refeeding syndrome moderate to severe electrolyte and fluid shifts occurring during a period of refeeding; hypophosphatemia is common, and heart failure sometimes occurs.

refeeding syndrome

moderate to severe electrolyte and fluid shifts occurring during a period of refeeding. Hypophosphatemia is common, and heart failure sometimes occurs.

refeeding syndrome

The tendency to develop dangerous illness usually within four days of resuming normal eating after a prolonged period of starvation. Low insulin production during starvation with breakdown of body fat and protein result in loss of intracellular electrolytes, especially phosphate. The shift to a carbohydrate metabolism causes increased insulin production which stimulates cellular uptake of phosphate from the blood. Low serum phosphate depletes ATP and causes rhabdomyolysis, respiratory and heart failure, hypotension, seizures and death. Monitoring of serum phosphate and intravenous phosphate supplementation are required.

refeeding

the process of restoring nutrition to a previously starved animal. This should initially consist of a diet of predominantly protein and fat, gradually becoming more complex.

refeeding syndrome
excessive dietary carbohydrate intake after a period of starvation leads to potentially fatal insulin-induced transport of phosphorus and potassium into cells.
References in periodicals archive ?
It may be helpful in such cases to implement a protocol including cognitive behavioural strategies to encourage patients to get the rest they need and boost their calorie intake as well as monitoring of water intake and clinical and laboratory parameters to guard against the development of refeeding syndrome and/or the potentially life-threatening complications associated with hyponatremia and rhabdomyolysis.
Refeeding syndrome was first recognized during the World War II, when returning prisoners of the Japanese who had been starved rapidly developed neurological and cardiovascular abnormalities after the institution of a normal diet [1].
The treatment of a recognized case of refeeding syndrome should include vitamin replacement, including thiamine and other members of the vitamin B complex.
Initiating a feeding regimen in patients with a high risk of refeeding syndrome should never be done hastily and without careful planning and advice from a dietician.
Although there are few predictive factors to identify patients most at risk for refeeding syndrome, they tend to be those who are the most underweight (less than 70% of their ideal body weight) and have low prealbumin levels.
Refeeding syndrome occurs within 24 to 48 hours after initiating oral, enteral, or parenteral feedings for the severely malnourished patient.
The refeeding syndrome consists of the metabolic disturbances that may be induced by feeding when malnourished patients are refed, whether orally, enterally or parenterally (11).
b) represents patients at risk of refeeding syndrome (12).
Nasogastric feeding with Osmolite (Abbott Australasia, Kurnell, NSW) was commenced at a slow rate of 40 ml per hour for 96 hours to reduce the risk of refeeding syndrome, then gradually increased over the next 48 hours to meet estimated nutritional requirements.
The refeeding syndrome has been well described (16-19) and is associated with considerable morbidity and mortality.
Due to an increased risk of refeeding syndrome in women with hyperemesis, initiation of nutritional support should be slow, particularly during the first week, to prevent dramatic changes in fluid and electrolyte status.