THE REFEEDING SYNDROME - AN APPROACH TO UNDERSTANDING ITS COMPLICATIONS AND PREVENTING ITS OCCURRENCE

The refeeding syndrome (RS) is a complication of nutritional support t hat potentially causes considerable morbidity and mortality. Compensat ory metabolic alterations secondary to chronic starvation predispose m alnourished patients to RS. Providing nutritional support initiates an intracellular shift of potassium, magnesium, and phosphate that resul ts in many adverse effects. The literature addressing RS focuses on on ly one electrolyte abnormality, hypophosphatemia; however, often all t hree electrolyte levels are perturbed. Thus RS should be characterized as a syndrome of generalized fluid and electrolyte imbalance. Recomme nded electrolyte supplementation and laboratory monitoring can help pr event the disorder in susceptible patients.