Comprehensive care of the patient with Refeeding Syndrome

<b>Introduction:</b> Refeeding syndrome (RS) is a serious complication of nutritional therapy in critically ill patients, to which patients on surgical wards are particularly vulnerable. It is a potentially life-threatening, complex metabolic disorder that occurs in response to the implementation of overly aggressive, inadequate adaptive patient nutritional therapy, often exacerbated by malnutrition. Moreover, if an appropriate diagnostic and therapeutic process is not undertaken, RS itself becomes the cause of subsequent systemic complications such as respiratory failure, neurological disorders, circulatory failure or seizures. Identified risk factors for RS are mostly modifiable.<b>Aim:</b> The article reviews the literature on the current knowledge and recommendations regarding RS and provides practical recommendations to assist surgeons in effectively diagnosing and managing the syndrome during the perioperative period.<b>Methods:</b> A database query was conducted to identify the most recent information related to the topic of this study.<b>Results:</b> Treatment of RS in critically ill patients undergoing surgery is challenging due to overlapping symptoms of the underlying disease and coexisting severe metabolic disorders. Current guidelines recommend a gradual increase in energy intake and regular monitoring of a patient's metabolic status (especially phosphorus, potassium, and magnesium levels) during nutritional treatment.<b>Conclusions:</b> It is necessary to regularly follow the recommendations of scientific societies, which will take into account the specificity of the treatment of patients in the perioperative period with Refeeding Syndrome in the context of coexisting diseases to improve the quality and safety of care of these patients.