Nutrition Flashcards
When does re-feeding syndrome occur?
2-5 days after nutrition is reinstated, although signs can be observed w/in hours of re-feeding or delayed for up to 10 days
What are the 6 metabolic derangements that occur with re-feeding syndrome
1) hypophosphatemia
2) hypokalemia
3) hypomagnesemia
4) Thiamine deficiency
5) Altered glucose homeostasis
6) fluid shifts
Why do metabolic derangements occur with re-feeding?
rapid shift between catabolic (breaking down muscle and fat) and anabolic (maintaining muscle mass) metabolism that occurs in response to insulin release associated with refeeding
Why does thiamine demand increase
cofactor for enzymes such as pyruvate dehydrogenase and alpha ketoglutarate dehydrogenase
What are clinical signs of re-feeding
Neurological (tremors, encephalopathy)
Cardiovascular (arrythmias, heart failure)
GI (anorexia, vomiting)
Hemolysis
Mods/death
What are three phases of protein catabolism in starvation (healthy animal)
1) rapid initial depletion:
2) gradual phase during which lean muscle mass is preserved in favor of fat mobilization and ketone body production
3) Preterminal rapid depletion of body protein
After what % of protein loss is death likely to occur
50%
Which areas in brain does thiamine deficiency affect?
oculomotor, vestibular and lateral geniculate nuclei
Clinical signs of thiamine deficiency
Vestibular ataxia, mentation changes, cervical ventroflexion and mydriasis with absent menace responses with potential progression to come and death
Why does hypomagnesemia occur in refeeding?
reduced dietary intake with concurrent excessive gastrointestinal or renal losses
increase in demand when starting to feed
Clinical signs of hypomagnesemia
ventricular and supraventricular arrhythmias, seizures, and hypertension
What kind of diet for re-feeding
high protein and fat, low carbohydrate
