1: Re-Feeding Syndrome

Question 1

What did NICE state are the 4 high-risk factors for re-feeding syndrome

Answer 1

(LUBE) Requires one of the following:

Little nutritional intake for 10-days

Unexpected weight loss 15% in 3-6 months

BMI <16

Electrolyte anomalies prior to re-feeding (hypokalaemia, hypophosphataemia, hypomagnesaemia)

Question 2

What did NICE state are medium risk factors for re-feeding syndrome

Answer 2

Two of:

BMI < 18.5

Unintentional weight loss 10% in 3-6 months

Little nutritional intake for 5d

History: alcohol-abuse, chemotherapy, diuretics, antacids

Question 3

What 3 metabolic anomalies are seen in re-feeding syndrome

Answer 3

1. Hypokalaemia
2. Hypophosphataemia
3. Hypomagnesaemia

Question 4

What can low magnesium cause

Answer 4

Torsades de pointes

Question 5

How is re-feeding syndrome prevented

Answer 5

If individual has not eaten for 5-days. Feed at less than 50% of requirements for 2-days

Question 6

How should individuals with re-feeding syndrome be managed

Answer 6

Feed at 10Kcal/Kg/d for 4-7d then gradually increase. Start oral vitamin B and thiamine