Refeeding Syndrome

Refeeding syndrome occurs in those who start to eat again after being in severe nutritional deficit for a prolonged period of time. The lower the BMI, the higher the risk of refeeding syndrome.

During the malnutritional period, metabolism in cells slows down. When giving food quickly, there's an Insulin boost that pushes magnesium, potassium and phosphorus into cells, therefore leading to:

• Hypomagnesaemia

• Hypokalaemia

• Hypophosphataemia

The patient is therefore at risk of Arrhythmias, HF, and Fluid overload.

Management

• Slow reintroduction of food w/restricted calories

• Routine bloods to monitor Mg, K, Phos, Glucose

• ECG monitoring

• Fluid balance monitoring

• Bloods - LF/FSH, TFTs

• Supplementation with electrolytes, vitamins (B and Thiamine/B1)