How Useful are Re-feeding Bloods for Paediatric Inpatients with Anorexia Nervosa?

Area of Science:

• Pediatric Endocrinology
• Clinical Nutrition
• Eating Disorders Management

Background:

• The 2012 Junior Management of Really Sick Patients with Anorexia Nervosa (MaRSiPAN) guidelines recommend daily blood testing for children during the first five days of inpatient re-feeding.
• This practice aims to monitor for re-feeding syndrome, a potentially dangerous complication.

Purpose of the Study:

• To evaluate the clinical utility of daily blood testing in children undergoing inpatient re-feeding for anorexia nervosa.
• To determine if the frequency of blood tests can be reduced without compromising patient safety.

Main Methods:

• A single-center retrospective study was conducted on pediatric patients admitted for anorexia nervosa treatment between January 2018 and August 2020.
• Data collected included weight, body mass index, and daily blood biochemistry results over the initial five days of re-feeding.
• Thirty-seven female patients aged 11-17 years were included in the analysis.

Main Results:

• All recorded blood biochemistry values, including phosphate levels (mean 1.22 mmol/L), remained within normal reference ranges throughout the five-day testing period.
• No biochemical evidence of re-feeding syndrome was detected in any patient.
• The daily blood test results did not lead to any changes in patient management.

Conclusions:

• Daily blood testing for pediatric patients with anorexia nervosa during the initial five days of inpatient re-feeding appears to have limited clinical utility.
• The findings suggest that a less frequent blood testing schedule may be appropriate, potentially reducing unnecessary procedures and healthcare costs.