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Etiology and Complications of Refeeding Syndrome in the ICU

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Diet and Nutrition in Critical Care

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Abstract

Refeeding syndrome is a group of electrolytic and metabolic disturbances that may occur as a result of nutritional support (oral, enteral, or parenteral), in severe malnourished patients. The syndrome was first described at the end of the Second World War and gained importance during the development of artificial nutrition. It is characterized by electrolyte disorders (hypophosphatemia, hypomagnesemia, and hypokalemia due to the movement of phosphate, magnesium, and potassium to the intracellular medium) and volume disbalance (water and sodium retention) mediated by insulin secretion during the reinstitution of nutrition. It can also appear as acute thiamine fall. The identification of patients at risk for developing refeeding syndrome should be a priority, in order to adjust the initial inputs of water, energy, electrolytes, and micronutrients.

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Abbreviations

ICU:

Intensive care unit

RS:

Refeeding syndrome

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Author information

Authors and Affiliations

  1. Servicio de Endocrinología y Nutrición, Complejo Hospitalario Universitario de Albacete. Universidad de Castilla-La Mancha, C/ Hermanos Falcó n° 37, 02006, Albacete, Spain

    José Joaquín Alfaro Martínez, Isabel Huguet Moreno, Francisco Botella Romero & Antonio Hernández López

Authors
  1. José Joaquín Alfaro Martínez
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  2. Isabel Huguet Moreno
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  3. Francisco Botella Romero
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  4. Antonio Hernández López
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Corresponding author

Correspondence to José Joaquín Alfaro Martínez .

Editor information

Editors and Affiliations

  1. Royal Free London Hospitals, Barnet General Hospital, London, UK

    Rajkumar Rajendram

  2. Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Rajkumar Rajendram

  3. King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia

    Rajkumar Rajendram

  4. Department of Nutrition and Dietetics, Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Victor R. Preedy

  5. Department of Biomedical Sciences, Faculty of Science & Technology, University of Westminster, London, UK

    Vinood B. Patel

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Alfaro Martínez, J.J., Huguet Moreno, I., Botella Romero, F., Hernández López, A. (2015). Etiology and Complications of Refeeding Syndrome in the ICU. In: Rajendram, R., Preedy, V.R., Patel, V.B. (eds) Diet and Nutrition in Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7836-2_22

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  • DOI: https://doi.org/10.1007/978-1-4614-7836-2_22

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