II. Risk Factors

  1. Chronic Malnutrition
  2. Alcoholism
  3. Electrolyte abnormalities

III. Pathophysiology

  1. Occurs in severely malnourished patients who undergo aggressive administration of Specialized Nutrition Support
  2. Rapid reintroduction of large amounts of carbohydrate
    1. Metabolism shifted to anabolic from catabolic
    2. Insulin released
    3. Cells uptake Potassium, phosphate, Magnesium, and water
  3. Results in severe Electrolyte abnormalities
    1. Hypophosphatemia
    2. Hypokalemia
    3. Hypomagnesemia

IV. Prevention

  1. Start refeeding at one third or less of nutritional needs and gradually increase every 5-7 days
  2. Administer Thiamine 100 mg IV daily for first week of Specialized Nutritional Support

V. Prognosis

  1. Life threatening complication if not recognized

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Ontology: Refeeding Syndrome (C0860549)

Definition (MSH) A condition of metabolic imbalance that is caused by complications of initially feeding a severely malnourished patient too aggressively. Usually occurring within the first 5 days of refeeding, this syndrome is characterized by WATER-ELECTROLYTE IMBALANCE; GLUCOSE INTOLERANCE; CARDIAC ARRHYTHMIAS; and DIARRHEA.
Concepts Disease or Syndrome (T047)
MSH D055677
SnomedCT 427698009
Dutch refeeding syndrome
German Refeeding-Syndrom, Refeeding Syndrom
Italian Sindrome da rialimentazione, Sindrome da refeeding
Portuguese Síndrome de realimentação, Síndrome da Realimentação, Síndrome de Realimentação
Spanish Síndrome de realimentación, síndrome de realimentación (trastorno), síndrome de realimentación, Síndrome de Realimentación
Japanese リフィーディング症候群, リフィーディングショウコウグン
English Refeeding syndrome, Refeeding syndrome (disorder), refeeding syndrome (diagnosis), refeeding syndrome, Refeeding Syndrome, Syndrome, Refeeding, Refeeding Syndrome [Disease/Finding], refeed syndrome
Czech Reperfúzní syndrom, realimentační syndrom, refeeding syndrom
French SRI (Syndrome de Renutrition Inappropriée), Syndrome de renutrition, Syndrome de réalimentation, Syndrome de renutrition inappropriée
Swedish Återuppfödningssyndrom
Polish Zespół ponownego odżywienia
Hungarian Refeeding syndroma
Norwegian Refeeding syndrom, Reernæringssyndrom