Refeeding Syndrome

Question 1

What is referring syndrome?

Answer 1

Refeeding syndrome is the potentially fatal shift of fluid and electrolytes that can occur in patients with prolonged starvation

Question 2

What energy source is used in the body in a prolonged fasted state?

Answer 2

The body switches from CHO metabolism to ketone bodies as its main energy source.

Question 3

What is the guidance for fluid in refeeding?

Answer 3

Give enough fluid as to not be dehydrated but total fluid should be controlled as cardiac capacity may be limited.

Question 4

What are the key minerals in refeeding syndrome

Answer 4

Potassium = K
Phosphorus = Ph
Magnesium = Mg

Question 5

What happens to minerals in RFS

Answer 5

K, Ph and Mg are taken into the cells which causes serum levels to fall rapidly.

Ph is needed to store ATP

Question 6

What vitamin is essential to be supplemented in RFS?

What is it needed for?

Answer 6

Thiamine

Thiamine is an essential coenzyme needed to metabolise CHO

Question 7

Why is it essential to limit fluids?

Answer 7

Fluid overload and electrolyte depletion can cause cardiac malfunction and a rapid increase in blood volume can cause cardiac failure.

Question 8

Management of Refeeding risk

Answer 8

Supplementation of B vitamins

Gradual reintroduction of calories - 1/4 portions, 1/2 portions, to full portions OR continuous tube feeding

Controlled fluid intakes

Vitamin and mineral supplementation -> high in K and Ph.