What is refeeding syndrome? Is Mr. Page at risk for this syndrome? How can it be prevented?

Question

What will be an ideal response?

Answer 1

• Refeeding syndrome is a term used to describe metabolic changes that occur as a result of repletion of malnourished individuals. Refeeding syndrome occurs after a period of starvation to which the body has adapted by metabolizing fat for energy instead of carbohydrate. When a carbohydrate-rich diet is reintroduced, thiamin, phosphorous, potassium, and magnesium are swiftly removed from the bloodstream into the cells for anabolism.
• This may result in electrolyte imbalances and shifts of fluid balance that accompany these changes. This can lead to heart failure and edema, acidosis, hyperventilation, and neurological dysfunction.
• Mr. Page is at risk due to his malnutrition, metabolic stress, and levels of electrolytes.
• Prevention of refeeding can be prevented by following these steps:
1) Obtain and correct baseline electrolytes (supplement K, Phos, Mg).
2) Initiate nutrition support with caution and at a low and slow rate (e.g., 15-20 kcal/kg or 3) Increase caloric intake gradually.
4) Monitor electrolytes closely (q 12 hr; 2x/day) for at least the first 3-5 days until Mr. Page is stable at his full caloric target.