Refeeding syndrome in patients with gastrointestinal fistula

Fan, Caibin; Ren, Jianan; Wang, Xinbo; Li, Jieshou

doi:10.1016/j.nut.2003.12.005

Cited by 33 publications

(32 citation statements)

References 36 publications

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“…From the present results, we can assume that the HP observed in this study was not a chronic but a transient symptom due to several reasons. The present and previous results show that plasma phosphate level decreases over several days and recovers after approximately 1 week . Most of these reports are about ‘refeeding syndrome’, which is observed in patients with severe malnutrition, anorexia and after operations.…”

Section: Discussionsupporting

confidence: 66%

“…The present and previous results show that plasma phosphate level decreases over several days and recovers after approximately 1 week. 12,[23][24][25] Most of these reports are about 'refeeding syndrome', which is observed in patients with severe malnutrition, anorexia and after operations. These reports imply that one of the reasons for the decrease in plasma phosphate observed in the present patients is refeeding.…”

Section: Discussionmentioning

confidence: 99%

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Hypophosphatemia among severely malnourished children with sepsis in Bangladesh

Yoshimatsu

Hossain

Islam

et al. 2012

Pediatrics International

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Hypophosphatemia among severely malnourished children with sepsis in Bangladesh

Yoshimatsu

Hossain

Islam

et al. 2012

Pediatrics International

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“…Starvation remains the most reliable predictor of RFS [28]. Nutritional risk screening 2002 ≥ 3 points, polymorbidity, older age, and low serum magnesium (<0.7 mmol/L) were found to be risk factors for RFS in many studies [19,20,28,[32][33][34][35][36][37][38]. According to the literature and to our long-lasting daily clinical experience, there are many clinical conditions at particular risk of developing RFS (see Table 1).…”

Section: Individual Risk Assessmentmentioning

confidence: 99%

Management of Refeeding Syndrome in Medical Inpatients

Reber

Friedli

Vasiloglou

et al. 2019

JCM

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Refeeding syndrome (RFS) is the metabolic response to the switch from starvation to a fed state in the initial phase of nutritional therapy in patients who are severely malnourished or metabolically stressed due to severe illness. It is characterized by increased serum glucose, electrolyte disturbances (particularly hypophosphatemia, hypokalemia, and hypomagnesemia), vitamin depletion (especially vitamin B1 thiamine), fluid imbalance, and salt retention, with resulting impaired organ function and cardiac arrhythmias. The awareness of the medical and nursing staff is often too low in clinical practice, leading to under-diagnosis of this complication, which often has an unspecific clinical presentation. This review provides important insights into the RFS, practical recommendations for the management of RFS in the medical inpatient population (excluding eating disorders) based on consensus opinion and on current evidence from clinical studies, including risk stratification, prevention, diagnosis, and management and monitoring of nutritional and fluid therapy.confirmed RFS have significant mortality rates and increased non-elective hospital readmission, thus confirming the negative effect of RFS on clinical outcome [5,6].Nutritional treatment is a central aspect of modern multimodal inpatient therapy. It aims to reduce complications and mortality rates, and to improve patients' quality of life and autonomy [5,7]. Even though well tolerated, nutritional treatment has a potential risk of complications, including RFS, which is an exacerbated response to the metabolic change from a starvation to a fed state as a consequence of large amount of food in the replenishment phase. RFS is characterized by an imbalance of electrolytes (mainly phosphate, potassium, and magnesium), vitamin disturbances (e.g., vitamin B1 thiamine deficiency), and fluid imbalances, as well as limited organ functions, in some cases leading to mortality [8][9][10][11][12]. This article highlights, discusses, and reviews RFS in medical inpatients (excluding patients with eating disorders) in terms of pathophysiological aspects, preventive measures, clinical manifestations, risk evaluation, diagnostic procedures, and treatment methods.

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“…Four studies examined unintentional weight loss 17 . ‐ 20 It is unknown whether weight loss predisposes to ECF development or is a consequence of the clinical course and management of the disease process. Weight loss is not surprising given the underlying diagnoses seen in patients who develop ECF (gastrointestinal cancer, trauma, intestinal obstruction, inflammatory bowel disease, radiation enteritis).…”

Section: Resultsmentioning

confidence: 99%

ASPEN‐FELANPE Clinical Guidelines

Kumpf

Aguilar-Nascimento

Graf

et al. 2016

J Parenter Enteral Nutr

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In adult patients with enterocutaneous fistula: (1) What factors best describe nutrition status? (2) What is the preferred route of nutrition therapy (oral diet, enteral nutrition, or parenteral nutrition)? (3) What protein and energy intake provide best clinical outcomes? (4) Is fistuloclysis associated with better outcomes than standard care? (5) Are immune-enhancing formulas associated with better outcomes than standard formulas? (6) Does the use of somatostatin or somatostatin analogue provide better outcomes than standard medical therapy? (7) When is home parenteral nutrition support indicated?

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Refeeding syndrome in patients with gastrointestinal fistula

Cited by 33 publications

References 36 publications

Hypophosphatemia among severely malnourished children with sepsis in Bangladesh

Hypophosphatemia among severely malnourished children with sepsis in Bangladesh

Management of Refeeding Syndrome in Medical Inpatients

ASPEN‐FELANPE Clinical Guidelines

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