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[Complications of renutrition]
1Service des Maladies Infectieuses et Tropicales - Nutrition Clinique, Hôpital Raymond-Poincaré, 104, boulevard R.-Poincaré, 92380 Garches. jean-claude.melchior@rpc.ap-hop-paris.fr
Annales De Medecine Interne
|February 15, 2001
Summary
Refeeding syndrome, a serious complication of artificial nutrition, can cause hypophosphatemia and electrolyte imbalances. Careful monitoring and preventive measures are crucial for malnourished patients receiving enteral or parenteral nutrition.
Area of Science:
- Clinical Nutrition
- Metabolic Disorders
- Patient Safety
Context:
- Artificial nutrition, including total parenteral nutrition (TPN) and enteral nutrition (EN), is vital for malnourished patients.
- Early use of TPN in the 1970s was associated with deaths due to the refeeding syndrome.
- The refeeding syndrome, characterized by metabolic disturbances, was previously documented in post-WWII populations.
Purpose:
- To review the complications associated with artificial nutrition, focusing on the refeeding syndrome.
- To highlight the metabolic disturbances, including hypophosphatemia, electrolyte overload, and neurological issues, associated with refeeding.
- To emphasize the importance of preventive strategies for artificial nutrition-related complications.
Summary:
- The refeeding syndrome encompasses hypophosphatemia, fluid/electrolyte overload, hypertonic states, vitamin deficiencies, and neurological disorders.
- Enteral nutrition complications primarily involve bronchial inhalation, while parenteral nutrition complications stem from venous access (e.g., thrombophlebitis, infection).
- Despite being uncommon, the potential severity of refeeding syndrome necessitates diligent preventive measures in malnourished patients.
Impact:
- Informs clinicians about the risks and management of refeeding syndrome and other artificial nutrition complications.
- Underscores the need for standardized guidelines and careful patient monitoring to ensure safety.
- Provides a foundation for developing specific treatment protocols, such as for hypophosphatemia.