Patients at high risk of refeeding syndrome.

 Patients at high risk of refeeding syndrome

Patient populations at risk for refeeding syndrome include those with:

·       anorexia nervosa and other restrictive eating disorders,

·       chronic conditions causing malnutrition (cancer, congenital heart disease),

·       malabsorptive syndromes (inflammatory bowel disease, cystic fibrosis),

·       High stress patient unfed for >7 days.

·       cerebral palsy

·       bariatric surgery

·       bowel resections

·       Patients with uncontrolled diabetes mellitus (electrolyte depletion, diuresis).

·       Long term users of antacids (magnesium and aluminum salts bind phosphate)

·       Long term users of diuretics (loss of electrolytes).

Early identification of high-risk patients is crucial. The NICE guidelines provide a useful tool in this regard:

References:

Jason M. Nagata and Andrea K. Garber, refeeding syndrome, Nelson 22th ed 2024, Vol 1, ch 63.

Mehanna HM, Moledina J, Travis J. Refeeding syndrome: what it is, and how to prevent and treat it. BMJ. 2008 Jun 28;336(7659):1495-8. doi: 10.1136/bmj. a301. PMID: 18583681; PMCID: PMC2440847.

Sachs, K., Andersen, D., Sommer, J., Winkelman, A., & Mehler, P. S. (2015). Avoiding Medical Complications During the Refeeding of Patients With Anorexia Nervosa. Eating Disorders, 23(5), 411–421. https://doi.org/10.1080/10640266.2014.1000111