Name four symptons of refeeding syndrome

Question 1

According to current guidelines what patients are at risk for refeeding syndrome

Answer 1

Patients with:
BMI lower than 16
Patients with unintended weightloss > 15 in the last 3-6 months
No or minimal intake (<100 kcal per 24 hrs) for more than 10 days
Low serum levels of elektrolytes K, P, Mg

Question 2

What are the strategies outlined in Friedli et al. (2018) ?

Answer 2

1. Daily monitoring of electrolytes and supplementation as needed
2. Administer 100-300 mg thiamine
3. Increase caloric intake gradually (5-10kcal/kg/day) over 4-10 days until the target volume is achieved
4. continuous monitoring of electrolyte levels, fluid balance, weight, nutritional rate, vital signs

Question 3

Why is the current evidence supporting the recommendations for managing RFS is characterized as not very strong?

Answer 3

The ‘evidence’is bases on clinical observations and expert consensus rather robuust clinical triaks
There is also no standardized protocol for RFS, leading to variability in practice.

Question 4

Why enteral nutrition generally more prefered that parental nutrition?

Answer 4

enteral nutrition in preferred due to reduced costs, fewer infectious complications and improved gut function.

Question 5

What complications can enteral feeding have?

Answer 5

gastroinstetinal isssues such nausea and vomiting. tube-related problems like misplacement and occlusion. Complications also include metabolic disturbance such as elektrolyte imbalances and nutrient deficiencies.

Question 6

In what kind of situations is enteral nutriton typically used?

Answer 6

In obstruction like esophageal tumors that block food passage.
Motility disorders where the stomach does not empty poperly.
Situations where patients can not consume enougj nutrition orally. Swallowing impairments

Question 7

What is reflux esophagitis?

Answer 7

A condition in which the stomach acid flow backward in to the esophagus, causing inflammation on the esophageal lining. poorly managed reflux esophagi’s can contribute to an increased risk of
developing esophageal cancer