Nutrition in clinical practice-the refeeding syndrome: illustrative cases and guidelines for prevention and treatment

Stanga, Z; Brunner, A; Leuenberger, M; Grimble, R F; Shenkin, A; Allison, S P; Lobo, D N (2008). Nutrition in clinical practice-the refeeding syndrome: illustrative cases and guidelines for prevention and treatment. European journal of clinical nutrition, 62(6), pp. 687-94. London: Nature Publishing Group 10.1038/sj.ejcn.1602854

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The refeeding syndrome is a potentially lethal complication of refeeding in patients who are severely malnourished from whatever cause. Too rapid refeeding, particularly with carbohydrate may precipitate a number of metabolic and pathophysiological complications, which may adversely affect the cardiac, respiratory, haematological, hepatic and neuromuscular systems leading to clinical complications and even death. We aimed to review the development of the refeeding syndrome in a variety of situations and, from this and the literature, devise guidelines to prevent and treat the condition. We report seven cases illustrating different aspects of the refeeding syndrome and the measures used to treat it. The specific complications encountered, their physiological mechanisms, identification of patients at risk, and prevention and treatment are discussed. Each case developed one or more of the features of the refeeding syndrome including deficiencies and low plasma levels of potassium, phosphate, magnesium and thiamine combined with salt and water retention. These responded to specific interventions. In most cases, these abnormalities could have been anticipated and prevented. The main features of the refeeding syndrome are described with a protocol to anticipate, prevent and treat the condition in adults.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Stanga-Nodari, Zeno and Leuenberger, Michèle Simone


600 Technology > 610 Medicine & health






Nature Publishing Group




Factscience Import

Date Deposited:

04 Oct 2013 14:56

Last Modified:

01 Oct 2020 11:47

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URI: (FactScience: 44411)

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