Refeeding Syndrome in Oncology: Report of Four Cases

Windpessl, Martin; Mayrbaeurl, Beate; Baldinger, C.; Tiefenthaller, Gernot; Prischl, Friedrich C.; Wallner, Manfred; Thaler, Josef

doi:10.14740/wjon1007w

Cited by 14 publications

(17 citation statements)

References 18 publications

(24 reference statements)

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“…Conversely, routine use of low‐sensitivity screening techniques may lead to unnecessary interventions, such as slow advancement of feedings toward the nutrition goal. Further, routine use of nonspecific screening has been shown to increase hospital length of stay and mortality 60‐63 …”

Section: Predictive Biomarkersmentioning

confidence: 99%

“…Serum electrolyte concentrations decreased again a week later, and the patient gained 9 kg, presumably fluids. Electrolytes were normalized with repletion during continued nourishment, and the patient was discharged after 3 weeks 63 . Additional case reports of RS in this population have been published 1,94 …”

Section: Populations Potentially At Risk For Refeeding Syndromementioning

confidence: 99%

“…Further, routine use of nonspecific screening has been shown to increase hospital length of stay and mortality. [60][61][62][63] Currently, the literature is too spare to recommend the routine use of biomarkers for clinical use for predicting RS. For the most part, biomarkers have only been studied for predicting risk of malnutrition and, by extension, are theorized to identify risk for RS.…”

Section: Predictive Biomarkersmentioning

confidence: 99%

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ASPEN Consensus Recommendations for Refeeding Syndrome

Silva¹,

et al. 2020

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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.

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Section: Predictive Biomarkersmentioning

confidence: 99%

Section: Populations Potentially At Risk For Refeeding Syndromementioning

confidence: 99%

Section: Predictive Biomarkersmentioning

confidence: 99%

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ASPEN Consensus Recommendations for Refeeding Syndrome

Silva¹,

et al. 2020

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“…Up to 50–80% of patients with advanced cancer are at high risk of developing RFS [ 74 ], in particular individuals with head and neck cancer [ 75 , 76 ]. Cancer cachexia cannot be arrested or reversed by any known form of nutritional, hormonal, or pharmacological treatment [ 77 ].…”

Section: Prevention and Treatmentmentioning

confidence: 99%

The Refeeding Syndrome: a neglected but potentially serious condition for inpatients. A narrative review

et al. 2020

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The Refeeding Syndrome (RFS) is a potentially serious, but still overlooked condition, occurring in individuals who are rapidly fed after a period of severe undernourishment. RFS derives from an abnormal electrolyte and fluid shifts leading to many organ dysfunctions. Symptoms generally appear within 2–5 days of re-feeding and may be absent/mild or severe and life threating, depending on the pre-existing degree of malnutrition and comorbidities. The lack of a standard definition and the nonspecificity of the symptoms make both incidence estimate and diagnosis difficult. In 2020, the American Society for Parenteral and Enteral Nutrition (ASPEN) proposed a unifying definition for the RFS and its severity classification. The awareness of the condition is crucial for identifying patients at risk, preventing its occurrence, and improving the management. The objectives of this narrative review were to summarize the current knowledge and recommendations about the RFS and to provide useful tips to help physicians to recognize and prevent the syndrome.

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“…Daten zur Inzidenz des Refeeding-Syndroms bei Patienten mit rheumatischen Krankheiten sind lückenhaft. Aus den publizierten Fallberichten lässt sich jedoch ein vorbestehender pa-thologischer Ernährungsstatus in allen Kasuistiken erfassen [12,26] [20]. Besonders Dialysepatienten sind durch einen gesteigerten Katabolismus aufgrund der chronischen Azidose, dem gestörten Hormonhaushalt und den dialysebedingten, persistierenden proinflammatorischen Signalen im Blut gefährdet.…”

Section: Gefährdete Patienten In Der Rheumatologieunclassified

Refeeding-Syndrom

et al. 2020

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ZusammenfassungRheumatische Krankheiten können über verschiedene Mechanismen zu einer Mangelernährung, also einer nicht ausreichenden Deckung des Bedarfs an Energie, Proteinen, Elektrolyten oder anderen Nährstoffen, führen. Bei Wiederbeginn mit vollwertiger Ernährung nach einer Phase einer solchen katabolen Stoffwechsellage kommt es zu metabolischen Veränderungen, die in einen akuten Mangel an verfügbaren Elektrolyten und anderen Mikronährstoffen führen und dann lebensbedrohliche Komplikationen auslösen können. Das Auftreten solcher Komplikationen nach Wiederbeginn der Ernährung wird als Refeeding-Syndrom bezeichnet. Mit Wissen um diese Komplikationen, dem adäquaten Wiederbeginn der Ernährung und ggf. einer Überwachung der relevanten Parameter sowie gezielter Supplementierung kann das Refeeding-Syndrom vermieden werden. In dieser Übersichtsarbeit werden die Pathomechanismen des Refeeding-Syndroms erklärt, die Risikofaktoren für das Auftreten des Refeeding-Syndroms – insbesondere unter Betrachtung von rheumatologischen Patienten – identifiziert und die nötige Therapie zur Vermeidung eines Refeeding-Syndroms bei Wiederbeginn der Ernährung dargestellt.

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Refeeding Syndrome in Oncology: Report of Four Cases

Cited by 14 publications

References 18 publications

ASPEN Consensus Recommendations for Refeeding Syndrome

ASPEN Consensus Recommendations for Refeeding Syndrome

The Refeeding Syndrome: a neglected but potentially serious condition for inpatients. A narrative review

Refeeding-Syndrom

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