Refeeding syndrome: an important complication after bariatric surgery

Silk, Zacharia; Jones, Lucy; Heath, Dugal

doi:10.1016/j.soard.2010.02.047

Cited by 15 publications

(12 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…RS has been described in obese patients who have underdone bariatric surgical procedures 77,78 . As with other conditions, the incidence and risk factors are unknown.…”

Section: Populations Potentially At Risk For Refeeding Syndromementioning

confidence: 99%

“…76 Bariatric Surgery and Bowel Resections RS has been described in obese patients who have underdone bariatric surgical procedures. 77,78 As with other conditions, the incidence and risk factors are unknown. One such case described a 48-year-old woman, admitted at 117 kg and a BMI of 41.5 for lithium overdose and protracted diarrhea, vomiting, and confusion.…”

Section: Alcohol and Substance-use Disordersmentioning

confidence: 99%

See 1 more Smart Citation

ASPEN Consensus Recommendations for Refeeding Syndrome

Silva¹,

et al. 2020

View full text Add to dashboard Cite

Introduction In the spring of 2017, the American Society for Parenteral and Enteral Nutrition (ASPEN) Parenteral Nutrition Safety Committee and the Clinical Practice Committee convened an interprofessional task force to develop consensus recommendations for identifying patients with or at risk for refeeding syndrome (RS) and for avoiding and managing the condition. This report provides narrative review and consensus recommendations in hospitalized adult and pediatric populations. Methods Because of the variation in definitions and methods reported in the literature, a consensus process was developed. Subgroups of authors investigated specific issues through literature review. Summaries were presented to the entire group for discussion via email and teleconferences. Each section was then compiled into a master document, several revisions of which were reviewed by the committee. Findings/Recommendations This group proposes a new clinical definition, and criteria for stratifying risk with treatment and screening strategies. The authors propose that RS diagnostic criteria be stratified as follows: a decrease in any 1, 2, or 3 of serum phosphorus, potassium, and/or magnesium levels by 10%–20% (mild), 20%–30% (moderate), or >30% and/or organ dysfunction resulting from a decrease in any of these and/or due to thiamin deficiency (severe), occurring within 5 days of reintroduction of calories. Conclusions These consensus recommendations are intended to provide guidance regarding recognizing risk and identifying, stratifying, avoiding and managing RS. This consensus definition is additionally intended to be used as a basis for further research into the incidence, consequences, pathophysiology, avoidance, and treatment of RS.

show abstract

“…RS has been described in obese patients who have underdone bariatric surgical procedures 77,78 . As with other conditions, the incidence and risk factors are unknown.…”

Section: Populations Potentially At Risk For Refeeding Syndromementioning

confidence: 99%

Section: Alcohol and Substance-use Disordersmentioning

confidence: 99%

ASPEN Consensus Recommendations for Refeeding Syndrome

Silva¹,

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Electrolyte disturbances may be seen in bariatric surgery patients receiving nutrition support. Hypokalemia and hypomagnesemia are characteristics of refeeding syndrome, which can manifest in a bariatric surgery patient when IV fluid resuscitation is initiated 131 . The standard electrolyte requirements for PN can be found in Table 2.…”

Section: Vitamin and Mineral Supplementation And Potential Deficienciesmentioning

confidence: 99%

“…The National Institute of Health and Clinical Excellence (NICE) reported on the factors associated with risk of refeeding syndrome 176 . While many bariatric patients will not present with subnormal BMI (BMI <18.5 kg/m 2 ), they may be malnourished from inadequate nutrient intake due to surgical complications 131 …”

Section: Nutrition Support In the Bariatric Patientmentioning

confidence: 99%

See 1 more Smart Citation

Nutrition and Metabolic Support Recommendations for the Bariatric Patient

et al. 2014

View full text Add to dashboard Cite

Managing the metabolic needs of the patient with obesity is a challenge unto itself without the added demands of accounting for an altered gastrointestinal tract. Nevertheless, with about 200,000 bariatric procedures being performed annually in the United States, clinicians must be prepared to manage the critically ill bariatric surgery patient. This article reviews the recent literature relating to nutrient needs and metabolic support for the bariatric patient. Bariatric patients are at risk for several micronutrient deficiencies, including vitamins D and B₁₂, calcium, and iron; some bariatric procedures affect macronutrient needs as well. Literature on nutrition support guidelines for the bariatric population is limited. However, with an understanding of the anatomical and physiological effects of bariatric surgery, recent guidelines for critically ill patients with obesity can be applied to the bariatric surgery population. The unique needs of the bariatric population, such as susceptibility to micronutrient deficiencies and specialized access routes, must be considered to provide safe and efficacious nutrition support. Further research is necessary to develop specific nutrition support recommendations for the bariatric population.

show abstract