Diferencia entre revisiones de «Refeeding syndrome»
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==Background== | ==Background== | ||
Mostly an issue with TPN, risk of death | Mostly an issue with TPN, risk of death. | ||
When a severely malnourished patient is given glucose, the following cascade of events takes place: | |||
*Insulin is released | |||
**this stimulates drive to produce ATP | |||
**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. | |||
**this leads to hypokalemia, hypomagnesemia, and hypophosphatemia. | |||
**Metabolic acidosis also develops. | |||
*Electrolyte abnormalities can cause prolonged QTc | |||
*Rapid phosphorus depletion can lead to hemolysis, hypotension, altered mental status. | |||
==Diagnosis== | ==Diagnosis== | ||
Revisión del 19:06 11 ene 2016
Background
Mostly an issue with TPN, risk of death.
When a severely malnourished patient is given glucose, the following cascade of events takes place:
- Insulin is released
- this stimulates drive to produce ATP
- 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.
- this leads to hypokalemia, hypomagnesemia, and hypophosphatemia.
- Metabolic acidosis also develops.
- Electrolyte abnormalities can cause prolonged QTc
- Rapid phosphorus depletion can lead to hemolysis, hypotension, altered mental status.
Diagnosis
Differential Diagnosis
- Fluid overload
- Insulin secretion
- Loss of myocardium
- Na absorption
- Mineral Depletion:
- Phosphorus
- K
- Na
- Mg
- Glucose Intoleraence
- Cardiac arrhythmas
- 1st wk
- Long QT