Refeeding syndrome in Southeastern Taiwan: Our experience with 11 cases

Chen, Li‐Ju; Chen, Huan-Lin; Bair, Ming‐Jong; Wu, Chia-Hsien; Lin, I-Tsung; Lee, Yuan-Kai; Chu, Cheng‐Hsin

doi:10.3748/wjg.v20.i30.10525

Cited by 9 publications

(27 citation statements)

References 22 publications

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“…Table 2 summarizes the consensus on the different recommendations. Most of the clinical trials focusing on risk factors for RFS are in agreement with criteria proposed by the NICE guidelines [14,[29][30][31][32][33][34]. Still, Goyale [35] and Zeki [36] reported low sensitivity and specificity of these factors to predict RFS.…”

Section: Clinical Manifestations Of Rfsmentioning

confidence: 68%

Management and prevention of refeeding syndrome in medical inpatients: An evidence-based and consensus-supported algorithm

et al. 2018

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Section: Clinical Manifestations Of Rfsmentioning

confidence: 68%

Management and prevention of refeeding syndrome in medical inpatients: An evidence-based and consensus-supported algorithm

et al. 2018

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“…RFS was defined in a variety of ways in the eligible studies; however, this was not a focus point in this review, given the recent systematic review on this topic 1 . Hypophosphatemia was a primary or secondary outcome measure in 16 studies (see Supplementary table), with 6 of these using its presence as the sole clinical sign for RFS development 21‐26 . The most stringent criteria were used by Hofer et al, 6 Matthews et al, 8 and Matthews et al, 9 defining RFS as peripheral edema or acute circulatory overload, organ function disturbance including respiratory failure or pulmonary edema, and severely low electrolyte levels 4 .…”

Section: Resultsmentioning

confidence: 99%

“…Half of the non–eating‐disorder studies (n = 7/13) reported the BMI of participants. Only 3 of these 24,33,34 had an average BMI in the underweight range (<19 kg/m 2 ) (see Table 1), with the remaining 4 studies reporting BMIs in a healthy to overweight range (BMI, 25–28 kg/m 2 ) 2,25,26,35 …”

Section: Resultsmentioning

confidence: 99%

“…Three of these studies did not report energy intakes in kcal/kg/d or an average weight of the participants in order to calculate this from kcal/d. These studies’ energy intakes ranged from 1355 to 1800 kcal/d 9,24,36 . Eight of these 15 studies were conducted with participants with eating disorders.…”

Section: Resultsmentioning

confidence: 99%

“…The remaining 7 studies were conservative studies, with 3 of these studies conducted with participants with eating disorders. Four studies reported reaching goal rate within 24–48 hours of commencing nutrition support 2,24,31,32 . All 4 of these studies were classified as assertive studies, with 1 study being in those with eating disorders.…”

Section: Resultsmentioning

confidence: 99%

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Systematic Review of Energy Initiation Rates and Refeeding Syndrome Outcomes

2020

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The limited, low‐level evidence available on refeeding syndrome (RFS) is likely a result of there being no universally accepted definition of RFS. Cautious feeding is typically recommended to prevent RFS‐related adverse outcomes; however, these recommendations are outdated. This systematic review aimed to summarize the RFS literature, describe feeding methods used, and determine whether higher or lower energy rates at commencement of feeding were associated with RFS or RFS‐related adverse outcomes. Databases were searched for interventional and observational studies examining feeding and RFS‐related adverse events in adult patients. Data extracted included study design, participant descriptions, energy intake, and incidence of RFS‐related adverse outcomes. Studies were compared based on assertive (>20 kcal/kg/d) or conservative (≤20 kcal/kg/d) feeding initiation rates. Of 2803 abstracts, 24 studies were included (1 randomized control trial, 23 observational studies). Fifteen studies were classified as assertive. Feeding methods varied greatly, making interpretations difficult. Incidence of hypophosphatemia varied widely and was reported at rates of up to 74% for assertive studies and 72% for conservative studies. Similarly, diagnosed RFS was reported at rates of up to 20% for both types of studies. Time to achieve goal feeding rate appeared to have no influence on incidence of RFS‐related adverse outcomes. No consensus was found regarding the best method of feeding, energy initiation, or the time to achieve goal feeding rate that minimizes risk of RFS. There is currently limited evidence to suggest that higher‐energy feeding initiation rates have detrimental impacts on those at risk of RFS; however, further research is necessary.

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The Refeeding Syndrome: a neglected but potentially serious condition for inpatients. A narrative review

et al. 2020

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The Refeeding Syndrome (RFS) is a potentially serious, but still overlooked condition, occurring in individuals who are rapidly fed after a period of severe undernourishment. RFS derives from an abnormal electrolyte and fluid shifts leading to many organ dysfunctions. Symptoms generally appear within 2–5 days of re-feeding and may be absent/mild or severe and life threating, depending on the pre-existing degree of malnutrition and comorbidities. The lack of a standard definition and the nonspecificity of the symptoms make both incidence estimate and diagnosis difficult. In 2020, the American Society for Parenteral and Enteral Nutrition (ASPEN) proposed a unifying definition for the RFS and its severity classification. The awareness of the condition is crucial for identifying patients at risk, preventing its occurrence, and improving the management. The objectives of this narrative review were to summarize the current knowledge and recommendations about the RFS and to provide useful tips to help physicians to recognize and prevent the syndrome.

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Refeeding syndrome in Southeastern Taiwan: Our experience with 11 cases

Abstract: Refeeding syndrome is an overlooked and risky disorder that has some potentially fatal complications. Nasogastric feeding in nursing homes is an important risk factor for patients and deserves greater attention based on the initial results of this study.

Cited by 9 publications

References 22 publications

Management and prevention of refeeding syndrome in medical inpatients: An evidence-based and consensus-supported algorithm

Management and prevention of refeeding syndrome in medical inpatients: An evidence-based and consensus-supported algorithm

Systematic Review of Energy Initiation Rates and Refeeding Syndrome Outcomes

The Refeeding Syndrome: a neglected but potentially serious condition for inpatients. A narrative review

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