Refeeding syndrome

Abstract

Refeeding syndrome is an uncommon but potentially fatal phenomenon that can occur in patients receiving parenteral, enteral, or oral feedings aft er a period of sustained malnutrition or starvation. Complications of the refeeding syndrome can include electrolyte abnormalities (hypophosphatemia, hypokalemia, hypomagnesemia), vitamin deficiency, heart failure, respiratory failure and even death. Symptoms of refeeding syndrome are variable, unpredictable and may occur without warning. In this article we would like to stress the importance of early identification of patients at risk; providing adequate electrolyte, vitamin, and micronutrient supplementation; careful fluid resuscitation; cautious and gradual energy restoration; and monitoring during refeeding.