Revisiting the refeeding syndrome: Results of a systematic review.

Friedli, Natalie; Stanga, Zeno; Sobotka, Lubos; Culkin, Alison; Kondrup, Jens; Laviano, Alessandro; Mueller, Beat; Schuetz, Philipp (2017). Revisiting the refeeding syndrome: Results of a systematic review. Nutrition, 35, pp. 151-160. Elsevier 10.1016/j.nut.2016.05.016

[img] Text
1-s2.0-S0899900716300909-main.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (507kB) | Request a copy

OBJECTIVE

Although described >70 y ago, the refeeding syndrome (RFS) remains understudied with lack of standardized definition and treatment recommendations. The aim of this systematic review was to gather evidence regarding standardized definition, incidence rate and time course of occurrence, association with adverse clinical outcomes, risk factors, and therapeutic strategies to prevent or treat this condition.

METHODS

We searched MEDLINE and EMBASE for interventional and observational clinical trials focusing on RFS, excluding case reports and reviews. We extracted data based on a predefined case report form and assessed bias.

RESULTS

Of 2207 potential abstracts, 45 records with a total of 6608 patients were included (3 interventional trials, 16 studies focusing on anorexic patients). Definitions for RFS were highly heterogenous with most studies relying on blood electrolyte disturbances only and others also including clinical symptoms. Incidence rates varied between 0% and 80%, depending on the definition and patient population studied. Occurrence was mostly within the first 72 h of start of nutritional therapy. Most of the risk factors were in accordance with National Institute for Health and Care Excellence guidelines, with older age and enteral feeding being additional factors. There was no strong evidence regarding association of RFS and adverse outcomes, as well as regarding preventive measures and treatment algorithms.

CONCLUSION

This systematic review focusing on RFS found consensus regarding risk factors and timing of occurrence, but wide variations regarding definition, reported incidence rates, preventive measures and treatment recommendations. Further research to fill this gap is urgently needed.

Item Type:

Journal Article (Original Article)

Division/Institute:

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

UniBE Contributor:

Stanga-Nodari, Zeno

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0899-9007

Publisher:

Elsevier

Language:

English

Submitter:

Lia Bally

Date Deposited:

21 Mar 2017 10:41

Last Modified:

25 Sep 2020 13:51

Publisher DOI:

10.1016/j.nut.2016.05.016

PubMed ID:

28087222

Uncontrolled Keywords:

Hypophosphatemia; Nutritional support; Nutritional therapy

BORIS DOI:

10.7892/boris.95090

URI:

https://boris.unibe.ch/id/eprint/95090

Actions (login required)

Edit item Edit item
Provide Feedback