User:Mr. Ibrahem/Refeeding syndrome

Refeeding syndrome is a condition that may occur following reintroduction of nutrition after a prolonged period of starvation. It may also occur with nutrition in the form of total parenteral nutrition. It may result in low phosphate, low magnesium, low potassium, and low thiamine. This may result in weakness, decreased breathing, poor coordination, confusion, seizures, and heart arrythmias.

Risk factors include eating disorders, alcoholism, following surgery, chronic malnutrition, bariatric surgery, and inflammatory bowel disease. The underlying mechanism involves increased blood sugar leading to increased insulin levels which results in uptake of potassium and phosphate by cells. Diagnosis is based on a decrease in blood levels of phosphate, potassium, or magnesium. Mild disease is a decrease of 10 to 20%, moderate disease a decrease of 20 to 30%, and severe disease a decrease of greater than 30%.

Treatment is by the gradual reintroduction of calories. In the first 24 hours, 10 to 20 kcal/kg or no more than half the person energy requirement, is recommended. Thiamine supplements should be given early. Potassium, phosphate, calcium, and magnesium supplements are also often recommended. Electrolytes should be measured every 12 hours initially.

Refeeding syndrome's frequency is unclear. One study found rates of 0.5% to 18% among people who had been hospitalized. Modern descriptions of the condition date from World War II. Though, a number of prior descriptions of people dying following eating after a famine occur throughout history.