Refeeding Syndrome

Excerpt

Increased nutrition following a prolonged period of starvation can result in refeeding syndrome. Refeeding syndrome is defined as medical complications that result from fluid and electrolyte shifts as a result of aggressive nutritional rehabilitation. Refeeding syndrome commonly occurs in populations at high risk for malnutrition ranging from patients with eating disorders to renal failure patients on hemodialysis. Metabolic disturbances manifest in cardiopulmonary, hematologic, and neurological dysfunction in these types of patients. Hypophosphatemia is considered a hallmark of refeeding syndrome; however, other electrolyte irregularities may also include but are not limited to decreased amounts of magnesium, potassium, and thiamine.

Despite the long-standing recognition of refeeding syndrome as a serious clinical complication with a high mortality rate that requires immediate medical intervention, high-quality scientific evidence on the etiology and management of refeeding syndrome is limited. Historically, early descriptions of this phenomenon date to documentation from World War II when individuals living during the famine unexpectedly became ill following nutritional reconstitution. In 1951, Schnitker et al. reported that one-fifth of Japanese prisoners starved in prison camps died suddenly after nutritional and vitamin replenishment.