Know Refeeding Syndrome: Eat a lot after fasting. Life threatening


What is Refeeding Syndrome?

Data from the Pediatric Nutrition Society states that refeeding syndrome is a complication that follows malnutrition after feeding. Especially those who are severely malnourished This causes the body to rapidly switch from the catabolic state (muscle degradation) into anabolic state (muscle building), reducing minerals and vitamins. Especially the minerals in the cells (intracellular ions), including phosphorus, potassium, magnesium and B vitamins, with a retention of water and sodium.

Why do you eat a lot of food? Immediately after fasting Is it dangerous to the body?

In patients who are malnourished or starved The body has to break down adipose tissue and protein. To be used as energy Decreased insulin secretion Minerals and vitamins In the body has a lower level When the body receives food, whether it is eaten by mouth. Give way through the digestive tract Or even intravenous water with sugar causes the body to turn back to glucose as energy. Insulin levels rise, bringing glucose into the cells. Inhibit the breakdown of fat And insulin is also active in the water and sodium (salt and water retention) metabolism of glucose. Need a lot of phosphorus The phosphorus level in the blood is rapidly lower. Potassium and magnesium move into the cell. Causing the level in the blood to drop The body needs vitamin B1, which is an increased cofactor of glucose metabolism.

Symptoms seen in Refeeding Syndrome patients

Patients will have symptoms. Vary the severity of the abnormal mineral Since the blood test has found low levels of minerals but no symptoms have been shown. Until there are disorders in various systems such as the cardiovascular system. Respiratory system, blood system, nervous system and muscles And severe until death

Low blood phosphorus

– Weakness, Numbness

– Diaphragm muscles malfunction

– respiratory failure

– The breakdown of red blood cells (hemolysis).

– abnormal heart function

– Symptoms of brain disease (encephalopathy)

– confusion, seizures


– Nausea, vomiting, constipation

– muscle weakness With muscle breakdown

– respiratory failure

– Abnormal heart muscle contractions

– heart arrhythmia

Low blood magnesium

– Weakness, muscle spasms

– loss of appetite, nausea, vomiting

– Liquid draining

– potassium levels And low calcium

– abnormal ECG Heart arrhythmia

– Confusion, convulsions, convulsions

Vitamin B1 deficiency

– The blood is acidic from congestion of lactic acid.

– muscle weakness

– heart attack

– confused

– Symptoms of brain disease (encephalopathy)

Mineral and mineral levels, both phosphorus. Lower potassium and magnesium affect the heartbeat. Cause irregular beats Muscle weakness Respiratory failure The breakdown of red blood cells (hemolysis), nausea, vomiting, seizures, vitamin B1 deficiency, which is associated with heart failure, confusion, lactic acidosis, muscle weakness. Together with the retention of water and sodium salt These changes can occur in the first few days after the patient begins to receive food.

How to prevent Refeeding Syndrome

Doctors and nurses will take care of Refeeding Syndrome patients with the realization that the patient Severe malnutrition or patients who have been fasting or not getting enough food for a while are at risk of Refeeding Syndrome.

– Start nutrition treatment gradually. Increase the energy the patient receives from 20-25% of their total energy needs at the end of the first week.

– Track levels of electrolytes and minerals Especially phosphorus, potassium, magnesium and calcium. And follow up at least once a day in the first week of nutrition therapy, if abnormal, treatment and follow up closely.

– Follow up on the amount of fluid that the patient receives Urine volume and changes in body weight

– Give vitamin B1 25-100 mg / day, oral or intravenous. Before starting feeding and continuing for 7-10 days

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