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Updated: May 29, 2026

Technical Considerations and Approach to Redo Foregut Surgery

Technical Considerations and Approach to Redo Foregut Surgery

Published on: September 22, 2023

Dietetic practice in refeeding syndrome.

¹Department of Nutrition & Dietetics, Royal Free Hospital, London, UK. georgina.wagstaff@nhs.net

Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association

|September 3, 2011

Summary

Dietitians have read NICE guidelines on refeeding syndrome but practice remains inconsistent. While some aspects are adopted, key recommendations on patient risk and nutrition rates are not universally followed, indicating a need for improved adherence.

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Published on: September 22, 2023

Area of Science:

Clinical Nutrition
Dietetics
Patient Management

Background:

Refeeding syndrome physiology and consequences are known, but management remains debated.
The National Institute for Health and Clinical Excellence (NICE) provided guidance in 2006.
Current dietetic practice and adherence to NICE recommendations require assessment.

Purpose of the Study:

To evaluate current dietetic opinions and practices concerning refeeding syndrome.
To determine the extent to which NICE (2006) recommendations have been adopted by dietitians.

Main Methods:

An anonymous, internet-based survey was distributed to dietitians in the London region.
The survey investigated current practices, opinions, and adherence to NICE guidance on refeeding syndrome.
Responses were collated and analyzed following the survey's closing date.

Main Results:

A 30.8% response rate was achieved, with 89.8% of participants having read the NICE guidance.
66.9% reported changing practice, yet 62% commence nutrition before biochemistry normalizes.
Inconsistent practices were observed in recognizing at-risk patients and initiating nutrition, with 75% reactively supplementing electrolytes.

Conclusions:

Dietetic practice for refeeding syndrome management shows inconsistency with NICE recommendations.
While some NICE guidelines have been adopted, universal adherence is lacking.
Further efforts are needed to align clinical practice with established evidence-based guidelines.