The purpose of this systematic review is to identify studies where measurable thiamine supplementation was provided to patients at risk for or with refeeding syndrome to improve treatment guidelines. A systematic review of PubMed and CINAHL Plus databases was conducted using the terms refeeding syndrome, hypophosphatemia, thiamine, and vitamin B1. A total of 173 articles were retrieved and 11 case studies and 1 retrospective study met inclusion criteria. All studies identified symptoms of thiamine deficiency, and all studies indicated thiamine supplementation was associated with improved clinical symptoms and no harmful outcomes. Average dose provided was 173-mg thiamine/day.
Background: The majority of evidence on efficacy of appetite-stimulating medications is limited to specific populations and the outpatient treatment setting. However, hospitalized adults remain at risk for poor appetite and inadequate intake.Method: The purpose of this review was to assess recent evidence on the efficacy of dronabinol, megestrol acetate, and mirtazapine (used to stimulate appetite) on promoting change in intake; somatic symptoms, such as appetite and nausea; and weight change during hospital stay. The population was limited to hospitalized adults or adults who demonstrated a need for appetite stimulation during hospitalization. Results: Of the 382 articles screened, four met inclusion criteria (one randomized control trial, two retrospective cohort studies, and one retrospective case series). Based on the studies included, these appetite stimulants have limited efficacy on improving appetite and meal intake. There was no significant change in weight.
Conclusion:Current data lack standardization, generalizability, and comparability, and higher quality evidence is needed before conclusions can be identified on the efficacy of dronabinol, megestrol acetate, and mirtazapine in the inpatient setting.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.