Dan Nugget
* Refeeding syndrome is a metabolic complication that occurs when nutritional support is given to severely malnourished patient
* It results from overly aggressively feeding patients who are severely malnourished or who haven’t eaten in a long period of time
* Results in a shift of potassium and phosphorus into the body’s cells for ATP production, resulting in electrolyte imbalance
* Insulin is released on carbohydrate intake, triggering cellular uptake of potassium, phosphate, and magnesium
* Refeeding a severely malnourished patient should occur gradually, and the patient should be monitored closely
* Nutritional support should initially be delivered at a maximum of 10 kcal/kg/day
* Raise gradually to full requirement within a week
* In extreme cases energy intake should be limited to 5 kcal/kg/day
* Characteristics of the Refeeding syndrome include:
*Hypophosphatemia*
*Hypokalemia*
*Hypomagnesemia*
*Hyperglycemia*
*Fluid retention*
*Cardiac arrest*
*Recommend the following*
* 200-300 mg oral thiamine a day, 1-2 strong tablets vitamin B co strong tablets (x3) or intravenous vitamin B, and a balanced multivitamin and mineral supplement/day should be recommended each day, before and during the first 10 days of feeding
* Monitor and recommend the following:
Oral, enteral, or intravenous potassium, phosphate and magnesium intake
# An average of 2-4 mmol/kg/day potassium, 0.3-0.6 mmol/kg/day phosphate, and 0.2 mmol/kg/day intravenous or 0.4 mmol/kg/day oral magnesium should be recommended
*In patients with serious comorbidity*
* Design the prescription to provide 50% of the nutritional needs initially
* Build up to a full prescription within 24-48 hours.
*STAY HEALTHY AND OBEY GOD*
*Maduforo Aloysius RDN*
Have a great day ahead
