[Complications of renutrition]

Several deaths were reported when total parenteral nutrition came into use in the early seventies. These deaths resulted from overzealous total parenteral nutrition leading to what was termed the refeeding syndrome. Actually, this syndrome had been reported years earlier, especially at the end of the second world war. The refeeding syndrome includes hypophosphatemia, water and electrolyte overload, hypertonic states, vitamin deficiencies and neurological disorders. Malnourished patients on enteral and/or parenteral nutrition are exposed to specific complications linked to artificial nutrition. Bronchial inhalation is the main complication of enteral nutrition, while the venous access is the source of most of the complications related to parenteral nutrition. Thrombophlebitis and infection of the central venous lines can be avoided by proper preventive measures. While refeeding syndrome and other metabolic complications is uncommon in malnourished patients on enteral or parenteral nutrition, the potential gravity of these complications implies careful preventive measures. A specific guideline for the treatment of phyophosphatemia is presented.