Refeeding syndrome - Revision history

Borzi: /* Pathophysiology */

2025-07-31T15:08:23Z

Pathophysiology

← Revisión anterior		Revisión del 15:08 31 jul 2025
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	**As ATP is produced, the cellular Na/K ATPase is activated, leading to transcellular movement of potassium and eventually other electrolytes, including magnesium, phosphorus and calcium into the cell.		**As ATP is produced, the cellular Na/K ATPase is activated, leading to transcellular movement of potassium and eventually other electrolytes, including magnesium, phosphorus and calcium into the cell.
	**this leads to [[hypokalemia]], [[hypomagnesemia]], and [[hypophosphatemia]].		**this leads to [[hypokalemia]], [[hypomagnesemia]], and [[hypophosphatemia]].
	**[[Metabolic ~~acidosis~~]] also develops.		**[[Metabolic alkalosis]] also develops from K+ shift into cells
			**Lactate can become elevated secondary to thiamine deficiency.
	*Electrolyte abnormalities can cause [[prolonged QTc]]		*Electrolyte abnormalities can cause [[prolonged QTc]]
	*Rapid phosphorus depletion can lead to [[hemolytic anemia\|hemolysis]], [[hypotension]], [[altered mental status]].		*Rapid phosphorus depletion can lead to [[hemolytic anemia\|hemolysis]], [[hypotension]], [[altered mental status]].

Rossdonaldson1: /* Management */

2022-03-12T13:39:51Z

Management

@@ Línea 52: / Línea 52: @@
 ==Management==
-===Management Recommendations for Avoidance and Treatment of RS in At-Risk Adults<ref>https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.10474 ASPEN Consensus guidelines]</ref>===
+===Adults<ref>https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.10474 ASPEN Consensus guidelines]</ref>===
 {| {{table}}
 | align="center" style="background:#f0f0f0;"|'''Aspect of Care'''
@@ Línea 94: / Línea 94: @@
 |-
 | ||Daily weights with monitored intake and output.
 |-
 | ||Evaluate short- and long-term goals for nutrition care daily during the first several days until the patient is deemed stabilized (eg, no requirement for electrolyte supplementation for 2 days) and then based on institutional standards of care.

Rossdonaldson1: /* Management */

2022-03-12T13:38:21Z

Management

← Revisión anterior		Revisión del 13:38 12 mar 2022
Línea 52:		Línea 52:

	==Management==		==Management==
	===~~ASPEN Consensus~~ Recommendations for Avoidance and Treatment of RS in At-Risk Adults<ref>https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.10474 ASPEN Consensus guidelines]</ref>===		===Management Recommendations for Avoidance and Treatment of RS in At-Risk Adults<ref>https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.10474 ASPEN Consensus guidelines]</ref>===
	{\| {{table}}		{\| {{table}}
	\| align="center" style="background:#f0f0f0;"\|'''Aspect of Care'''		\| align="center" style="background:#f0f0f0;"\|'''Aspect of Care'''

Rossdonaldson1 at 13:37, 12 March 2022

2022-03-12T13:37:42Z

← Revisión anterior		Revisión del 13:37 12 mar 2022
Línea 52:		Línea 52:

	==Management==		==Management==
	===ASPEN Consensus Recommendations for Avoidance and Treatment of RS in At-Risk Adults<ref></ref>===		===ASPEN Consensus Recommendations for Avoidance and Treatment of RS in At-Risk Adults<ref>https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.10474 ASPEN Consensus guidelines]</ref>===
	{\| {{table}}		{\| {{table}}
	\| align="center" style="background:#f0f0f0;"\|'''Aspect of Care'''		\| align="center" style="background:#f0f0f0;"\|'''Aspect of Care'''
Línea 102:		Línea 102:

	==External Links==		==External Links==
	*[https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.10474 ASPEN Consensus guidelines]'		*[https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.10474 ASPEN Consensus guidelines]

	==References==		==References==

Rossdonaldson1: /* Management */

2022-03-12T13:37:06Z

Management

@@ Línea 52: / Línea 52: @@
 ==Management==
+===ASPEN Consensus Recommendations for Avoidance and Treatment of RS in At-Risk Adults<ref></ref>===
 ==See Also==

Rossdonaldson1 at 13:29, 12 March 2022

2022-03-12T13:29:28Z

← Revisión anterior		Revisión del 13:29 12 mar 2022
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	==Management==		==Management==

	~~'''[https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.10474 ASPEN Consensus guidelines]'''~~

	==See Also==		==See Also==
Línea 59:		Línea 58:

	==External Links==		==External Links==
			*[https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.10474 ASPEN Consensus guidelines]'

	==References==		==References==

Rossdonaldson1 at 23:29, 15 February 2022

2022-02-15T23:29:23Z

← Revisión anterior		Revisión del 23:29 15 feb 2022
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	==See Also==		==See Also==
	*[[Nutrition (main)]]		*[[Nutrition (main)]]

			==External Links==

	==References==		==References==

Sunnyd89: /* Management */

2022-02-15T22:55:09Z

Management

← Revisión anterior		Revisión del 22:55 15 feb 2022
Línea 52:		Línea 52:

	==Management==		==Management==

			'''[https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.10474 ASPEN Consensus guidelines]'''

	==See Also==		==See Also==

ClaireLewis: /* Differential Diagnosis */

2019-09-29T16:33:02Z

Differential Diagnosis

← Revisión anterior		Revisión del 16:33 29 sep 2019
Línea 32:		Línea 32:
	**[[hypomagnesemia\|Mg]]		**[[hypomagnesemia\|Mg]]
	*Glucose Intolerance		*Glucose Intolerance
	*[[~~Cardiac~~ arrhythmias]]		*Cardiac [[arrhythmias]]
	**1st wk		**1st wk
	**[[Long QT]]		**[[Long QT]]

ClaireLewis at 16:32, 29 September 2019

2019-09-29T16:32:44Z

← Revisión anterior		Revisión del 16:32 29 sep 2019
Línea 8:		Línea 8:
	**As ATP is produced, phosphorus is depleted		**As ATP is produced, phosphorus is depleted
	**As ATP is produced, the cellular Na/K ATPase is activated, leading to transcellular movement of potassium and eventually other electrolytes, including magnesium, phosphorus and calcium into the cell.		**As ATP is produced, the cellular Na/K ATPase is activated, leading to transcellular movement of potassium and eventually other electrolytes, including magnesium, phosphorus and calcium into the cell.
	**this leads to hypokalemia, hypomagnesemia, and hypophosphatemia.		**this leads to [[hypokalemia]], [[hypomagnesemia]], and [[hypophosphatemia]].
	**Metabolic acidosis also develops.		**[[Metabolic acidosis]] also develops.
	*Electrolyte abnormalities can cause prolonged QTc		*Electrolyte abnormalities can cause [[prolonged QTc]]
	*Rapid phosphorus depletion can lead to hemolysis, hypotension, altered mental status.		*Rapid phosphorus depletion can lead to [[hemolytic anemia\|hemolysis]], [[hypotension]], [[altered mental status]].

	==Clinical Features==		==Clinical Features==
	*Fluid overload, [[CHF]]		*[[Fluid overload]], [[CHF]]
	*[[Altered mental status]]		*[[Altered mental status]]
	*[[Seizure]]		*[[Seizure]]
	*[[Rhabdomyolysis]]		*[[Rhabdomyolysis]]
	*Hemolysis		*[[hemolytic anemia\|Hemolysis]]
	*Symptomatic from hypophosphatemia, hypokalemia, hypomagnesemia		*Symptomatic from [[hypophosphatemia]], [[hypokalemia]], [[hypomagnesemia]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	**Na absorption		**Na absorption
	*Mineral Depletion:		*Mineral Depletion:
	**Phosphorus		**[[hypophosphatemia\|Phosphorus]]
	**K		**[[hypokalemia\|K]]
	**Na		**[[hyponatremia\|Na]]
	**Mg		**[[hypomagnesemia\|Mg]]
	*Glucose ~~Intoleraence~~		*Glucose Intolerance
	*[[Cardiac ~~arrhythmas~~]]		*[[Cardiac arrhythmias]]
	**1st wk		**1st wk
	**[[Long QT]]		**[[Long QT]]
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	*[[ECG]]: May cause [[prolonged QTc]]		*[[ECG]]: May cause [[prolonged QTc]]
	*[[Hypophosphatemia]]		*[[Hypophosphatemia]]
	**Leading to hemolysis, [[hypotension]], [[altered mental status]]		**Leading to [[hemolytic anemia\|hemolysis]], [[hypotension]], [[altered mental status]]

	==Management==		==Management==