Refeeding syndrome commonly occurs in populations at high risk for malnutrition ranging from patients with eating disorders to renal failure patients on Background The incidence of refeeding syndrome (RFS) in critically ill patients is high, which is detrimental to their prognoses. Gusella and colleagues [41] compared parent led therapy (PLT) to non-specific therapy (psychologist led talking therapy). Refeeding syndrome: A literature review. One of the main guidelines used for the evaluation and treatment of refeeding syndrome is the National Institute for Health Care and Excellence (NICE) Studies included both male and female patients, however, out of 25 patient focused studies, most had a female majority and 6 studies [20, 26, 37, 39, 43, 44] were conducted on female only cohorts. Refeeding syndrome symptoms and warning signs typically appear early in the refeeding process, and require immediate medical intervention upon observation. There is no high-quality evidence on this. Both these pathways are dysregulated in acute stress, but the magnitude of this deregulation cannot be assessed in clinical practice. Maginot et al., 2017 [18] and Whitelaw et al., 2010 [9] reported NG bolus feeding in 13.8 and 15% in order to supplement oral diet with a mean weight gain of 3.1kgs and 2.6kgs respectively but did not report if this was specific to NG feeding. Accessibility Certain conditions may increase your risk for this condition, including anorexia, alcohol use disorder, and more. 2019;34(3):35970. Refeeding syndrome is a serious and potentially fatal condition that can occur during refeeding. Due to the anticipated paucity of studies in this area any research where a meaningful conclusion or result can be drawn regarding NG use in YP with ED will be included. Aggressive repletion of electrolytes, with the exception of calcium (IV calcium may exacerbate hypophosphatemia). Therefore, it is important for all patients with extreme forms of anorexia and ARFID to initiate nutritional rehabilitation in an inpatient medical setting that specializes in preventing, identifying and managing this potentially fatal complication. In addition, refeeding often occurs alongside other serious conditions that typically require simultaneous treatment. The inclusion criteria were: NG feeding, participants under 18years, eating disorders, published since 2000 and primary research. Refeeding syndrome: What it is, and how to prevent and treat it. It seems logical to avoid administering insulin if possible (e.g., allowing glucose to rise to ~200-300 mg/dL). The most frequent indication for HPN was mechanical obstruction (277, 45.7%), followed by short bowel syndrome (SBS, 208, 34.3%) and intestinal fistula (46, 7.59%). Nurs Times. Akgul S, Pehlivanturk-Kizilkan M, Ors S, Derman O, Duzceker Y, Kanpur N. Type of setting for the inpatient adolescent with an eating disorder: are specialized inpatient clinics a must or will the pediatric ward do? Family-based treatment (FBT) is a psychotherapy shown to be effective in a number of randomized controlled trials in physically stable patients with anorexia nervosa (AN), under the age of 19, and within 3 years of illness. McCray S, et al. Twenty-nine studies met the full criteria. Garber AK, Sawyer SM, Golden NH, Guarda AS, Katzman DK, Kohn MR, et al. Percent of BG hours in the 4.48.0mmol/L range highest under standard STAR conditions (78%), and was lower at 64% under UL-9, likely due to reduced time-responsiveness of nutrition-insulin changes. National Center for Biotechnology Information National Collaborating Centre for Mental Health. KH gathered data and interpreted results. RH was found in 37% (10/27). https://doi.org/10.24953/turkjped.2016.06.010. A total of 1247 patients were eligible (618 early-PN, 629 late-PN). The above became the aim of this study. Results have shown that NG feeding is used commonly in the hospital setting to treat medical instability as a result of severe malnourishment, and in the specialist eating disorders (ED) unit due to failure to meet oral intake. In 13 studies (3 high risk of bias [28, 35, 47]) in which NG was not implemented as standard protocol for all patients, the percentage of ED YP administered NG feeding in all contexts (due to medical instability or inadequate oral diet) varied between 6 and 66% [9, 18, 29, 31, 36, 37, 41,42,43,44]. American Psychiatric Association. Development and validation of risk prediction model for UpToDate https://doi.org/10.1176/appi.ajp.159.8.1347. The pooled impact of refeeding syndrome on length of stay of 2634 patients in 10 studies was weighted mean difference (WMD)=2.91 (95% CI,0.18 6.00; P=0.065) days. How to Gain Weight Fast: Tips to Be Safe and Healthy, Diabulimia: Why This Eating Disorder Is So Dangerous for People with Diabetes. Shifts in electrolyte levels can cause serious complications, including seizures, heart failure, and comas. 2015;45(2):41527. Journal of Eating Disorders Together, these processes can lead to decreased concentrations of minerals in the blood, of which hypophosphatemia is the most characteristic [14]. The average length of stay in patients with refeeding syndrome was 25.55 days with a very high heterogeneity between studies. 29002-0025.) Child and adolescent mental health service, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, National Guideline Alliance (UK). Nutr Clin Pract. Further research is warranted to determine whether refeeding syndrome prolongs the length of stay, and to verify the effect of different energy intakes during refeeding on the length of stay in people with malnutrition. Am J Psychiatry. Nutritional glucose intake affects blood glucose (BG) outcomes, but few protocols actively control it. British Dietetic Association. Kwashiorkor and marasmus are forms of undernutrition. See additional information. Privacy Nasogastric tube feeding in line with new dietetic guidelines for the treatment of anorexia nervosa in a specialist children and adolescent inpatient unit: a case series. CF performed the discussion. As a result, prevention is critical. The underlying health conditions that increase the risk of refeeding syndrome arent always preventable. The pooled length of stay of 2965 patients with refeeding syndrome in 11 studies was 25.55 (95% CI, 20.2030.90) days. WebBACKGROUND. Moreover, for clinicians, there is currently conflicting guidance on how to manage NG feeding in YP with ED, in particular how and when to transition between oral and NG feeding [20, 21]. Patients with restrictive eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS), are predominantly female (91%) and Caucasian (92%), with incidence being approximately 0.014 for females [3]. The results of this review support the conclusions from Rizzo and colleagues [49] (2019) that NG feeds can be safely administered and have the advantage of shortening LOS when used to increase total caloric intake. Refeeding https://doi.org/10.1111/1747-0080.12058. The Refeeding Syndrome: a neglected but potentially serious
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