Refeeding syndrome is a slippery topic. It's probably more common than we recognize, often running underneath the radar (the constellation of electrolyte and clinical abnormalities can easily masquerade as another problem, such as alcohol withdrawal). However, there is essentially no prospective evidence on how to prevent or treat it. Indeed, there is no clear consensus definition of exactly what refeeding syndrome is. As such, it's difficult to know precisely aggressively we should search out and treat this entity.
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The IBCC chapter is located here.
- The podcast & comments are below.
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ASPEN released new adult and pediatric refeeding syndrome criteria this year including a new clinics definition and recommendations for prevention and treatment.
wow, this just came out a few weeks ago so I missed it while reviewing literature for this chapter, I’m revising the chapter now to be consistent with these guidelines, thanks !!
Talking out my ass, but I remember reading about things like cholera and dysentery in “austere” environments, and things like WHO rehydration salts ( and various versions of same), and cautionary tales about how you “re-feed” somebody that’s been extended NPO for whatever reason. Same thing?
Rehydration salts – also know as “oral rehydration solutions (ORS)” are still widely in use and recommended in many guidelines. They are a safer alternative to iv fluids in malnourished patients and are still widely used in Africa at least.
Hi there, thanks for the amazing podcast on this topic! I was wondering what the clinical considerations are in a patient with insulin dependent diabetes who suffers from refeeding syndrome?
Kind regards,
Andre
Hi Josh,
I am curious to know how we could identify refeeding syndrome in patients with renal dysfunctioning? Hypophosphatemia, hypokalemia and hypomagnesemia might be masked in these patients. Furthermore, how can we identify refeeding syndrome in patients on renal replacement therapy such as continuous venovenous hemofiltration as electrolyte depletions might be a result of this.