This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Kraft, M. D. Articles by Sacks, G. S. Search for Related Content PubMed PubMed Citation Articles by Kraft, M. D. Articles by Sacks, G. S. Pubmed/NCBI databases Medline Plus Health Information Metabolic Disorders Social Bookmarking                         What's this?

Review of the Refeeding Syndrome

Michael D. Kraft, PharmD^*,
Imad F. Btaiche, PharmD, BCNSP^*,
Gordon S. Sacks, PharmD, BCNSP

^* Department of Clinical Sciences, College of Pharmacy, University of Michigan, Ann Arbor, Michigan; Department of Pharmacy Services, University of Michigan Health System, Ann Arbor, Michigan; and the Pharmacy Practice Division, School of Pharmacy, University of Wisconsin–Madison, Madison, Wisconsin

Correspondence: Correspondence: Michael D. Kraft, PharmD, Clinical Assistant Professor and Clinical Pharmacist, University of Michigan Health System, Department of Pharmacy Services, UH/B2 D301, Box 0008, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0008. Electronic mail may be sent to mdkraft{at}umich.edu.

Refeeding syndrome describes a constellation of metabolic disturbances that occur as a result of reinstitution of nutrition to patients who are starved or severely malnourished. Patients can develop fluid and electrolyte disorders, especially hypophosphatemia, along with neurologic, pulmonary, cardiac, neuromuscular, and hematologic complications. We reviewed literature on refeeding syndrome and the associated electrolyte abnormalities, fluid disturbances, and associated complications. In addition to assessing scientific literature, we also considered clinical experience and judgment in developing recommendations for prevention and treatment of refeeding syndrome. The most important steps are to identify patients at risk for developing refeeding syndrome, institute nutrition support cautiously, and correct and supplement electrolyte and vitamin deficiencies to avoid refeeding syndrome. We provide suggestions for the prevention of refeeding syndrome and suggestions for treatment of electrolyte disturbances and complications in patients who develop refeeding syndrome, according to evidence in the literature, the pathophysiology of refeeding syndrome, and clinical experience and judgment.

Nutrition in Clinical Practice, Vol. 20, No. 6, 625-633 (2005)
DOI: 10.1177/0115426505020006625


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				C. Nyirenda, I. Zulu, E. K Kabagambe, S. Bagchi, D. Potter, C. Bosire, Z. Krishnasami, and D. C Heimburger Acute hypophosphataemia and hypokalaemia in a patient starting antiretroviral therapy in Zambia--a new context for refeeding syndrome? BMJ Case Reports, April 2, 2009; 2009(apr01_2): bcr0720080469 - bcr0720080469. [Abstract] [Full Text]

				J. D. C. Machado, V. M. M. Suen, F. B. Chueire, J. F. M. Marchini, and J. S. Marchini Refeeding syndrome, an undiagnosed and forgotten potentially fatal condition BMJ Case Reports, March 5, 2009; 2009(mar02_1): bcr0720080521 - bcr0720080521. [Abstract] [Full Text]

				J. P. Caplan Too Much Too Soon? Refeeding Syndrome as an Iatrogenic Cause of Delirium Psychosomatics, May 1, 2008; 49(3): 249 - 251. [Abstract] [Full Text] [PDF]

				S. J. Miller Death Resulting From Overzealous Total Parenteral Nutrition: The Refeeding Syndrome Revisited Nutr Clin Pract, April 1, 2008; 23(2): 166 - 171. [Abstract] [Full Text] [PDF]

				B.-G. Fan Effects of Parenteral Nutrition on the Exocrine Pancreas in Response to Cholecystokinin JPEN J Parenter Enteral Nutr, January 1, 2008; 32(1): 57 - 62. [Abstract] [Full Text] [PDF]

				A. F. Newton and M. H. DeLegge Home Initiation of Parenteral Nutrition Nutr Clin Pract, February 1, 2007; 22(1): 57 - 64. [Abstract] [Full Text] [PDF]

				J. A. Palesty and S. J. Dudrick The Goldilocks Paradigm of Starvation and Refeeding Nutr Clin Pract, April 1, 2006; 21(2): 147 - 154. [Full Text] [PDF]

				M. F. Winkler Improving Safety and Reducing Harm Associated With Specialized Nutrition Support Nutr Clin Pract, December 1, 2005; 20(6): 595 - 596. [Full Text] [PDF]