Refeeding syndrome
Refeeding syndrome is a potentially fatal metabolic and fluid complication of restarting nutrition in a severely malnourished or starved person; insulin shifts phosphate, potassium and magnesium into cells, while carbohydrate use can expose thiamine deficiency and sodium-water retention can cause fluid overload.
Definition
Refeeding syndrome is a potentially fatal metabolic and fluid complication that can occur when nutrition is reintroduced or increased in a significantly malnourished or starved person. It is characterised by an acute post-feeding fall in phosphate, often with potassium and magnesium shifts, and may include thiamine deficiency, sodium-water retention and organ dysfunction.
First principles
Normal serum values do not prove normal body stores
During starvation, insulin falls and the body uses fat and protein. Total-body phosphate, potassium and magnesium become depleted while serum concentrations may remain deceptively normal. A normal pre-feeding result therefore does not remove risk.
This page is exam revision material, not medical advice, and must not be used for patient care. Always check drug doses against the BNF and current guidance. Full disclaimer.