Refeeding syndrome: clinical and nutritional relevance

Arq Bras Cir Dig. 2012 Jan-Mar;25(1):56-9. doi: 10.1590/s0102-67202012000100013.
[Article in English, Portuguese]

Abstract

Introduction: Feedback syndrome is characterized clinically by neurological alterations, respiratory symptoms, arrhythmias and heart failure few days after refeeding. It happens due to severe electrolyte changes, such as hypophosphatemia, hypomagnesemia and hypokalemia associated with metabolic abnormalities that may occur as a result of nutritional support (oral, enteral or parenteral) in severely malnourished patients.

Objective: To evaluate its causes and the preventive dietary measures aiming to reduce the morbimortality.

Methods: Was conducted literature review in SciELO, LILACS, Medline / PUBMED, Cochrane Library and government websites in Portuguese, English and Spanish. The survey was about the last 15 years, selecting the headings: refeeding syndrome, malnutrition, hypophosphatemia, hypokalemia, hypomagnesemia.

Conclusion: The monitoring of metabolic parameters and electrolyte levels before starting nutritional support and periodically during feeding should be based on protocols and the duration of therapy. Patients at high risk and other metabolic complications should be followed closely, and depletion of minerals and electrolytes should be replaced before starting the diet. A multidisciplinary team of nutrition therapy can guide and educate other health professionals in prevention, diagnosis and treatment of the syndrome.

Publication types

  • Review

MeSH terms

  • Humans
  • Refeeding Syndrome* / etiology
  • Refeeding Syndrome* / prevention & control