Refeeding syndrome
Refeeding syndrome | |
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Unintentional weight loss : 37–38 |
Refeeding syndrome is a
Cause
Any individual who has had a negligible nutrient intake for many consecutive days and/or is metabolically stressed from a critical illness or major surgery is at risk of refeeding syndrome. Refeeding syndrome usually occurs within four days of starting to re-feed. Patients can develop fluid and electrolyte imbalance, especially hypophosphatemia, along with neurologic, pulmonary, cardiac, neuromuscular, and hematologic complications.[citation needed]
During
During refeeding, insulin secretion resumes in response to increased
Clinical situations
The syndrome can occur at the beginning of treatment for eating disorders when patients have an increase in calorie intake and can be fatal. It can also occur when someone does not eat for several days at a time usually beginning after 4–5 days with no food. [4] It can also occur after the onset of a severe illness or major surgery. The shifting of electrolytes and fluid balance increases cardiac workload and heart rate. This can lead to acute heart failure. Oxygen consumption is increased which strains the respiratory system and can make weaning from ventilation more difficult.[citation needed]
Diagnosis
Refeeding syndrome can be fatal if not recognized and treated properly. The electrolyte disturbances of the refeeding syndrome can occur within the first few days of refeeding. Close monitoring of blood biochemistry is therefore necessary in the early refeeding period.[citation needed]
Treatment
In critically ill patients admitted to an
History
In his 5th century
There were numerous cases of refeeding syndrome in the Siege of Leningrad during World War II, with Soviet civilians trapped in the city having become malnourished due to the German blockade.[8]
A common error, repeated in multiple papers, is that "The syndrome was first described after World War II in Americans who, held by the
Refeeding syndrome has also been documented among survivors of the Ebensee concentration camp upon their liberation by the United States Army in May 1945. After liberation, the inmates were fed rich soup; the stomachs of a few presumably could not handle the sudden caloric intake and digestion, and they died.[10][11]
It is difficult to ascertain when the syndrome was first discovered and named, but it is likely the associated electrolyte disturbances were identified perhaps in Holland, the Netherlands during the so-called Hunger Winter, spanning the closing months of World War II.[12]
See also
References
- ^ a b "Evidence — Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition — Guidance". National Institute for Health and Care Excellence (NICE). 22 February 2006 [Updated 4 August 2017]. Web page with link to full guideline CG32.
- ^ PMID 18583681.
- ^ PMID 26597128.
- PMID 22041604.
- ^ Hippocrates of Kos. De Carnibus. 5th century BCE.
- ^ The Wars of the Jews by Flavius Josephus. October 2001. p. book V, chapter XIII, paragraph 4. Retrieved 2018-05-22 – via www.gutenberg.org.
- ^ "Researchers play detective to track earliest case of medical malady | The Asahi Shimbun: Breaking News, Japan News and Analysis". The Asahi Shimbun. Retrieved 2024-01-31.
- PMID 21686764.
- PMID 14847450.
- ^ Persinger, Robert B. "Remembering Ebensee 1945 Robert B. Persinger, May 6th 2005". Memorial Ebensee. Archived from the original on 7 October 2011.
- ^ Nawyn, Kathleen J. "The Liberation of the Ebensee Concentration Camp, May 1945". history.army.mil. U.S. Army Center of Military History. Retrieved 1 October 2018.
- .
Bibliography
- Shils, M.E., Shike, M., Ross, A.C., Caballero, B. & Cousins, R.J. (2006). Modern nutrition in health and disease, 10th ed. Lippincott, Williams & Wilkins. Baltimore, MD.
- Mahan, L.K. & Escott-Stump, S.E. (2004) Krause's Food, Nutrition, & Diet Therapy, 11th ed. Saunders, Philadelphia, PA.
- Hearing S (2004). "Refeeding syndrome: Is underdiagnosed and undertreated, but treatable". BMJ. 328 (7445): 908–9. PMID 15087326.
- Crook M, Hally V, Panteli J (2001). "The importance of the refeeding syndrome". Nutrition. 17 (7–8): 632–7. PMID 11448586.
- Lauts N (2005). "Management of the patient with refeeding syndrome". J Infus Nurs. 28 (5): 337–42. S2CID 39877542.
- Kraft M, Btaiche I, Sacks G (2005). "Review of the refeeding syndrome" (PDF). Nutr Clin Pract. 20 (6): 625–33. PMID 16306300.
- "Evidence — Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition — Guidance". National Institute for Health and Care Excellence (NICE). 22 February 2006 [Updated 4 August 2017]. Web page with link to full guideline CG32.