| Mr. Ibrahem/Refeeding syndrome | |
|---|---|
 | |
| Starvation from one month in a Viet Cong prison camp in 1966. | |
| Specialty | Gastroenterology |
| Symptoms | Weakness, decreased breathing, poor coordination, confusion, seizures, heart arrythmias[1] |
| Risk factors | Eating disorders, alcoholism, post surgery, chronic malnutrition, bariatric surgery, inflammatory bowel disease[1] |
| Diagnostic method | Based on history and blood tests after ruling out other possible causes[1] |
| Treatment | Gradual reintroduction of calories, vitamin and mineral supplements[1] |
| Frequency | Unclear[1] |
Refeeding syndrome is a condition that may occur following reintroduction of nutrition after a prolonged period of starvation.[1] It may also occur with nutrition in the form of total parenteral nutrition.[1] It may result in low phosphate, low magnesium, low potassium, and low thiamine.[1] This may result in weakness, decreased breathing, poor coordination, confusion, seizures, and heart arrythmias.[1]
Risk factors include eating disorders, alcoholism, following surgery, chronic malnutrition, bariatric surgery, and inflammatory bowel disease.[1] The underlying mechanism involves increased blood sugar leading to increased insulin levels which results in uptake of potassium and phosphate by cells.[1] Diagnosis is based on a decrease in blood levels of phosphate, potassium, or magnesium.[1] Mild disease is a decrease of 10 to 20%, moderate disease a decrease of 20 to 30%, and severe disease a decrease of greater than 30%.[1]
Treatment is by the gradual reintroduction of calories.[1] In the first 24 hours, 10 to 20 kcal/kg or no more than half the person energy requirement, is recommended.[2][1] Thiamine supplements should be given early.[1] Potassium, phosphate, calcium, and magnesium supplements are also often recommended.[2] Electrolytes should be measured every 12 hours initially.[1]
The frequency of refeeding syndrome is unclear.[1] One study found rates of 0.5% to 18% among people who had been hospitalized.[1] Modern descriptions of the condition date from World War II.[1] Though, a number of prior descriptions of people dying following eating after a famine occur throughout history.[3][4]
References edit
- ^ a b c d e f g h i j k l m n o p q r s t Persaud-Sharma, D; Saha, S; Trippensee, AW (January 2021). "Refeeding Syndrome". PMID 33232094.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b Mehanna HM, Moledina J, Travis J (June 2008). "Refeeding syndrome: what it is, and how to prevent and treat it". BMJ. 336 (7659): 1495–8. doi:10.1136/bmj.a301. PMC 2440847. PMID 18583681.
- ^ "Refeeding Syndrome in Historical Perspective: Its First Description by Rodulfus Glaber (1033)" (PDF). AJBSR. January 7 2021. doi:10.34297/AJBSR.2021.11.001644. Retrieved 7 March 2021.
{{cite journal}}: Check date values in:|date=(help) - ^ De Santo, Natale G; Bisaccia, Carmela; Phillips, Malcolm E; De Santo, Luca S (11 December 2020). "Refeeding syndrome as described in 1507 by Antonio Benivieni in Florence". Nephrology Dialysis Transplantation. doi:10.1093/ndt/gfaa295. PMID 33313827.