Refeeding Syndrome

Question 1

What is refeeding syndrome and who is at risk

Answer 1

metabolic abnormalities after feeding someone following a period of starvation.

extended period of catabolism ends abruptly with switching to carbohydrate metabolism

Question 2

Metabolic disturbance seen in refeeding syndrome

Answer 2

hypophosphataemia
hypokalaemia
hypomagnesaemia (torsades de pointes)
abnormal fluid balance

Question 3

Patients at risk of refeeding syndrome

Answer 3

One or more of:
- BMI < 16 kg/m2
- weight loss >15% 3-6 months
- poor intake > 10 days
- hypokalaemia
hypophosphataemia or hypomagnesaemia prior to feeding

If two or more of the following:
- BMI < 18.5 kg/m2
- weight loss > 10% 3-6 months
- poor intake > 5 days
- alcohol use, chemotherapy

Question 4

If a patient hasn’t eaten for > 5 days, how quickly does NICE recommend that you refeed?

Answer 4

no more than 50% of requirements for the first 2 days.