engleski

Refeeding Syndrome in Children: Risk Assessment, Diagnostics and Management

Refeeding syndrome is a well-described state of the series of metabolic and biochemical changes that occur during the supplemental feeding of malnourished patients. The shifts in fluids and electrolytes can lead to complications during artificial feeding and if not recognized and untreated can lead to death. Although the physiology and pathophysiology is well known, the circumstances under which the syndrome appears, clinical manifestations and management of these patients is less clear. To date, there are no published randomized controlled studies for refeeding syndrome in paediatric population. Published studies are generally lower level of evidence (level 3 and 4) that include cohort studies, case reports and expert opinions. After brief report of pathophysiology, we described refeeding syndrome cases from our clinical practice. Mainly, occurrence in pediatric patients has been reported in children with cancer. Then follow the patients with primary gastroenterological or neurological disease in the intensive care unit. In this chapter we describe risk assessment by defining the degree of malnutrition and planning of nutrition support. Baseline biochemical tests and laboratory monitoring, using reference change value of the most important analytes, can identify refeeding syndrome before symptoms appear. In this regard, the refeeding syndrome is laboratory diagnoses that provide a signal for treatment that is significantly simplified and includes termination of feeding, correction of electrolytes and continuation of feeding gradually and slowly.

Parenteral Nutrition, Refeeding syndrome, Child, laboratory diagnostics

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