scholarly journals Refeeding syndrome: Screening, incidence, and treatment during parenteral nutrition

2013 ◽  
Vol 28 ◽  
pp. 113-117 ◽  
Author(s):  
Russell S Walmsley
Keyword(s):  
Parenteral Nutrition ◽  
Refeeding Syndrome

SUN-LB645: Parenteral Nutrition in Surgical ICU: Refeeding Hypophosphatemia or Refeeding Syndrome?

2019 ◽  
Vol 38 ◽  
pp. S299
Author(s):  
A. Yaroshetskiy ◽  
V. Konanykhin ◽  
S. Stepanova ◽  
N. Resepov
Keyword(s):  
Parenteral Nutrition ◽  
Refeeding Syndrome ◽  
Surgical Icu

Response to Letter re: Refeeding syndrome in adults receiving total parenteral nutrition: An audit of practice at a tertiary UK centre

2019 ◽  
Vol 38 (2) ◽  
pp. 968 ◽  
Author(s):  
Konstantinos C. Fragkos ◽  
Simona Di Caro ◽  
Shameer J. Mehta ◽  
Farooq Rahman
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Refeeding Syndrome

scholarly journals Quality improvement initiative to reduce adverse effects associated with parenteral nutrition overfeeding

2018 ◽  
Vol 10 (1) ◽  
pp. 67-71 ◽  
Author(s):  
Andrew J Franck
Keyword(s):  
Quality Improvement ◽  
Amino Acid ◽  
Parenteral Nutrition ◽  
Outcome Measures ◽  
Liver Dysfunction ◽  
Bloodstream Infections ◽  
Quality Improvement Initiative ◽  
Refeeding Syndrome ◽  
The Mean ◽  
The Impact

ObjectiveParenteral nutrition (PN) overfeeding is a potential risk factor in the development of infections and other complications including hyperglycaemia, refeeding syndrome and liver dysfunction. This study was conducted to evaluate the impact of a quality improvement initiative to reduce PN overfeeding.DesignRetrospective cohort study of a quality improvement initiative.SettingA health system comprised of two US Department of Veterans Affairs medical centres.PatientsPatients receiving PN.InterventionsMethods to reduce overfeeding included the use of standardised PN products with lower dextrose to amino acid ratios, reduced use of intravenous lipid emulsion (ILE), and use of adjusted body weights or guideline-recommended predictive equations for energy requirements.Main outcome measuresThe primary outcome measures were the doses of kilocalories, amino acids and ILE in each cohort. The proportions of patients developing complications before and after the intervention were evaluated.ResultsThe mean maximum total daily kilocalorie dose was 30.2 kcal/kg/day in the preintervention group (n=86) vs 23.4 kcal/kg/day in the postintervention group (n=62) (p<0.001). More patients in the postintervention group received reduced ILE during the first week of PN therapy compared with the preintervention group (p<0.001). The mean maximum total daily amino acid dose in each group was not significantly different. Significantly fewer cases of central line-associated bloodstream infections, hyperglycaemia and liver dysfunction were observed in the postintervention group.ConclusionsA quality improvement initiative to reduce PN overfeeding was effective in reducing kilocalorie and ILE doses while maintaining similar amino acid doses. Observed complications were reduced following the intervention.

scholarly journals Refeeding syndrome in small ruminants receiving parenteral nutrition

2020 ◽  
Vol 34 (4) ◽  
pp. 1674-1679
Author(s):  
Daniela Luethy ◽  
Darko Stefanovski ◽  
Raymond W. Sweeney
Keyword(s):  
Parenteral Nutrition ◽  
Small Ruminants ◽  
Refeeding Syndrome

scholarly journals Role of Thiamine in Refeeding Syndrome in Children

2021 ◽  
Vol 6 (2) ◽  
Keyword(s):  
Case Report ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Tertiary Care ◽  
Intestinal Resection ◽  
Current Evidence ◽  
Care Hospital ◽  
Refeeding Syndrome ◽  
Wide Range

Purpose, Setting and Subjects: We conducted a case report study of a postoperative pediatric patient on total parenteral nutrition managed by a multidisciplinary team in a tertiary care hospital. In October 2020, data of nutritional status, hypophosphatemia, electrolyte and metabolic imbalance, and the role of thiamine supplement were reviewed. Background: Refeeding Syndrome is usually defined as the possibly lethal maldistribution of fluids and electrolytes that could take place in malnourished patients receiving enteral or parenteral refeeding. This is due to hormonal and metabolic disturbances that may lead to critical clinical deterioration. The biochemical key feature of Refeeding Syndrome is hypophosphatemia. In general, the syndrome is complicated and may also incorporate abnormal electrolytes and fluid balance; changes in serum level of protein, glucose, and the metabolism of fat; thiamine deficiency; hypokalemia; and hypomagnesaemia. Case Report: an ex-preterm 6-year-old boy who underwent major intestinal resection due to necrotizing enterocolitis (NEC) during his stormy neonatal period, presented to ED with constipation for 2 days; the patient was admitted in the pediatric ward under combined care with Pediatric Surgery, as a case of large bowel obstruction for conservative management. He had cachexic appearance, global developmental delay (GDD), and faltering growth. Subsequently and during his PICU stay, he suffered a fluctuating course of electrolytes imbalance a few days after commencing total parenteral nutrition (TPN), and developed altered mental status that responded well to thiamine infusions to resume his baseline sensorium within 48 hours. Conclusions: The role of thiamine in Refeeding Syndrome is extremely underestimated, despite the current evidence of its high efficacy. However, the fussy exclusion mechanism to reach the diagnosis is probably the reason behind the delaying of treatment in most of the cases. A wide range of patients are at risk of developing Refeeding Syndrome, especially malnourished children, as in this case report. Categories: Nutrition, Surgery, Pediatrics, Gastroenterology.

scholarly journals Hypophosphatemia and risk of refeeding syndrome in critically ill patients before and after nutritional therapy

2020 ◽  
Vol 66 (9) ◽  
pp. 1241-1246
Author(s):  
Amanda Coelho Ribeiro ◽  
Diana Borges Dock-Nascimento ◽  
João Manoel Silva Jr. ◽  
Cervantes Caporossi ◽  
José Eduardo de Aguilar-Nascimento
Keyword(s):  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Nutritional Therapy ◽  
Tertiary Hospital ◽  
Serum Phosphorus ◽  
Refeeding Syndrome ◽  
Before And After ◽  
Phosphorus Levels

Summary OBJECTIVE: To investigate the prevalence of hypophosphatemia as a marker of refeeding syndrome (RFS) before and after the start of nutritional therapy (NT) in critically ill patients. METHODS: Retrospective cohort study including 917 adult patients admitted at the intensive care unit (ICU) of a tertiary hospital in Cuiabá-MT/Brasil. We assessed the frequency of hypophosphatemia (phosphorus <2.5mg/dl) as a risk marker for RFS. Serum phosphorus levels were measured and compared at admission (P1) and after the start of NT (P2). RESULTS: We observed a significant increase (36.3%) of hypophosphatemia and, consequently, a greater risk of RFS from P1 to P2 (25.6 vs 34.9%; p<0.001). After the start of NT, malnourished patients had a greater fall of serum phosphorus. Patients receiving NT had an approximately 1.5 times greater risk of developing RFS (OR= 1.44 95%CI 1.10-1,89; p= 0.01) when compared to those who received an oral diet. Parenteral nutrition was more associated with hypophosphatemia than either enteral nutrition (p=0,001) or parenteral nutrition supplemented with enteral nutrition (p=0,002). CONCLUSION: The frequency of critically ill patients with hypophosphatemia and at risk for RFS on admission is high and this risk increases after the start of NT, especially in malnourished patients and those receiving parenteral nutrition.

Refeeding syndrome in hospitalizes patients with parenteral nutrition: Association with clinical outcomes

2018 ◽  
Vol 37 ◽  
pp. S227-S228
Author(s):  
M.C.C. kumbier ◽  
A.P.C. meira ◽  
C. oliveira ◽  
C. kasmirscki ◽  
F.M. silva
Keyword(s):  
Parenteral Nutrition ◽  
Clinical Outcomes ◽  
Refeeding Syndrome
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