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Refeeding Syndrome in the Critically Ill: a Literature Review and Clinician's Guide
C L McKnight1, C Newberry2, M Sarav3
1Department of Trauma/Surgical Critical Care, University of Tennessee-Knoxville, 1924 Alcoa Highway Box U-11, Knoxville, TN, 37920, USA. cmcknight@utmck.edu.
Current Gastroenterology Reports
|November 24, 2019
Summary
Refeeding syndrome (RFS) remains a critical issue in intensive care, lacking standardized diagnostic and management protocols. Multidisciplinary care and established criteria can improve outcomes for malnourished patients receiving nutritional support.
Area of Science:
- Critical care medicine
- Clinical nutrition
- Metabolic disorders
Background:
- Refeeding syndrome (RFS) poses a significant threat to critically ill patients.
- Current diagnostic and management strategies for RFS lack standardization.
- Accurate nutrition assessment tools for critically ill patients are not universally established.
Purpose of the Study:
- To review current methodologies for diagnosing and managing refeeding syndrome.
- To highlight the challenges in the critically ill patient population.
- To emphasize the need for standardized protocols.
Main Methods:
- Review of current literature on refeeding syndrome diagnosis and management.
- Analysis of existing clinical assessment tools.
- Discussion of multidisciplinary team approaches.
Main Results:
- No universally accepted definition or diagnostic "gold standard" for RFS exists.
- National Institute for Health and Clinical Excellence criteria are currently the most effective clinical assessment tool.
- Early identification and management by a multidisciplinary team can reduce RFS-related morbidity and mortality.
- Electrolyte imbalances during nutritional support can precipitate severe complications.
Conclusions:
- Standardizing nutrition care plans and RFS protocols is crucial for critically ill patients.
- A multidisciplinary approach is essential for effective RFS management.
- Implementing standardized protocols can decrease complication rates and mortality associated with RFS.
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