Refeeding Syndrome

Complication after re-commencement of enteral or parenteral nutrition after a period of starvation

Glucose intake triggerss Insulin secretion and subsequently shift of PO4, K and Mg into the intracellular space.

Complications

Respiratory

Respiratory failure

Respiratory muscle weakness

Cardiac

Cardiac failure

Hypotension

Arrhythmias

Neurology

Altered mental state

Confusion

Coma

Seizures

Renal

ATN

Skeletal

Rhabdomyolysis

Weakness

Endocrine

Insulin resistance

Osteomalacia

Haematologic

White Cell dysfunction

Thrombocytopenia

Hemolytic anemia

Depletion of 2,3 PDG (left shift of oxygen binding curve) and ATP result in tissue hypoxia and failure of cellular energy metabolism

Immune function

Sepsis