Refeeding in the ICU: an adult and pediatric problem

• Published in: Current opinion in clinical nutrition and metabolic care Vol. 14; no. 2; pp. 186 - 192
• Main Authors: Byrnes, Matthew C, Stangenes, Jessica
• Format: Journal Article
• Language: English
• Published: England Lippincott Williams & Wilkins, Inc 01-03-2011
• Subjects: Adult; Child; Critical Care; Critical Illness - therapy; Humans; Nutritional Support - adverse effects; Refeeding Syndrome - complications; Refeeding Syndrome - etiology; Risk Factors; Starvation - physiopathology; Starvation - therapy
• ISSN: 1363-1950; 1473-6519
• DOI: 10.1097/MCO.0b013e328341ed93

PURPOSE OF REVIEWTo describe the etiology and complications of the refeeding syndrome.
RECENT FINDINGSComplications of the refeeding syndrome can include electrolyte abnormalities, heart failure, respiratory failure, and death. This syndrome is of particular importance to critically ill patients, who can be moved from the starved state to the fed state rapidly via enteral or parenteral nutrition. There are a variety of risk factors for the development of the refeeding syndrome. All of these risk factors are tied together by starvation physiology. Case reports and case series continue to be reported, suggesting that this entity continues to exist in critically ill patients. Initiation of enteral nutrition to patients with starvation physiology should be gradual and careful monitoring of electrolytes and organ function is critical during the early stages of refeeding.
SUMMARYThe refeeding syndrome remains a significant issue in critically ill patients. Knowledge of the risk factors and the clinical signs of the refeeding syndrome is important to optimize outcomes.