How do you help someone with refeeding syndrome?

How do you help someone with refeeding syndrome?

People with refeeding syndrome need to regain normal levels of electrolytes. Doctors can achieve this by replacing electrolytes, usually intravenously. Replacing vitamins, such as thiamine, can also help to treat certain symptoms. A person will need continued vitamin and electrolyte replacement until levels stabilize.

What is a serious complication of refeeding syndrome?

Outlook. Refeeding syndrome appears when food is introduced too quickly after a period of malnourishment. Shifts in electrolyte levels can cause serious complications, including seizures, heart failure, and comas. In some cases, refeeding syndrome can be fatal.

How do you manage avoidant restrictive food intake disorder?

Regardless of one’s weight status, cognitive behavioral therapy (CBT) can be employed to help ARFID patients change the thought patterns that underlie their eating disturbance. Exposure therapy may also help patients tolerate anxiety-provoking foods or the physical process of consuming feared foods.

How do you prevent refeeding syndrome in recovery?

“the risk of refeeding syndrome should be avoided through gradual increase of caloric intake and close monitoring of weight, vital signs, fluid shifts and serum electrolytes”.

What do you monitor for refeeding syndrome?

Plasma electrolytes, in particular sodium, potassium, phos- phate, and magnesium, should be monitored before and during refeeding, as should plasma glucose and urinary electrolytes.

What should I watch with refeeding syndrome?

Complications from refeeding syndrome may include:

  • Blood pressure changes.
  • Bowel obstruction.
  • Cardiac arrest.
  • Confusion.
  • Diarrhea.
  • Fluid retention.
  • Heart rhythm changes.
  • Paralysis.

What is the hallmark of refeeding syndrome?

The hallmark biochemical feature of refeeding syndrome is hypophosphataemia. However, the syndrome is complex and may also feature abnormal sodium and fluid balance; changes in glucose, protein, and fat metabolism; thiamine deficiency; hypokalaemia; and hypomagnesaemia.

Why is thiamine used in refeeding syndrome?

THIAMINE IN REFEEDING SYNDROME 5,14 Thiamine deficiency is likely in refeeding syndrome because of increased metabolic needs. Thiamine is required as a co- factor in many of the metabolic pathways that are upregulated once feeding is reinitiated.

How is food aversion treated?

Slowly increasing your exposure to the taste you have an aversion to can prevent you from feeling sick or disgusted about the taste. Try just smelling it first, then taste a small amount.

What is the best therapy for ARFID?

ARFID treatment will likely include cognitive-behavioural therapy, or CBT, a “talk” therapy that helps individuals identify and change self-destructive patterns of thought and behaviour. CBT also treats anxiety, depression and obsessive compulsive disorder, which often co-occur with ARFID.

How do you monitor for refeeding syndrome?


  1. Follow lytes including Mg & Phosphate for three days.
  2. If phosphate falls <1.5 mg/dL (0.5 mM) this indicates refeeding syndrome –> see treatment below.

How do I monitor refeeding?

Why do electrolytes drop in refeeding syndrome?

Refeeding syndrome involves metabolic abnormalities when a malnourished person begins feeding, after a period of starvation or limited intake. In a starved body, there is a breakdown of fat and muscle, which leads to losses in some electrolytes like potassium, magnesium, and phosphate.

What happens to sodium in refeeding syndrome?

Sodium: The major influence on the serum sodium level during the refeeding phase is the shift of sodium out of the cell as the potassium is pumped back into the cell (sodium-potassium-ATPase pump). In addition, the increased insulin level in the early phase of refeeding leads to sodium retention in the kidneys.

How can I help my child with food aversion?

The secret is to start small and increase the challenge in baby steps. Begin by having at least one meal together as a family at the table. Modeling is such a powerful learning tool. Then advance to having whatever food the family is presented on the child’s plate, making sure to include a “safe” food at all meals.

How do you treat ARFID in children?

Treatment approaches for ARFID can include a combination of medical nutrition therapy, behavioral interventions, psychotherapy, family-based treatment, and medication management. Families play an important role in helping a child to recover from ARFID and are in no way to blame for this complex feeding disorder.

How is ARFID dietitian treated?

ARFID often is treated through anxiety management and systematic desensitization, gradually rewarding the introduction of new foods. Relaxation techniques are used to minimize stress. A safe environment should be created where feared foods are slowly integrated into the eating plan.

How do you assess for refeeding syndrome?

According to these guidelines, patients at the highest risk for refeeding syndrome meet one or more of the following criteria:

  1. Body mass index (BMI) under 16;
  2. Weight loss of more than 15 percent of his or her body weight in the past 3 to 6 months;
  3. Little to no food for the past 10 or more consecutive days; or.

What do you monitor in refeeding syndrome?

What are the treatment guidelines for refeeding syndrome?

If your patient is at risk for refeeding syndrome, follow these guidelines to prevent or minimize problems. Monitor serum electrolyte levels and make sure they’re normal before beginning nutritional support. Watch particularly for abnormal levels of potassium, phosphate, and magnesium. If they aren’t normal, they should be corrected promptly.

What is refeeding syndrome and what causes it?

Refeeding syndrome can be defined as the potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial refeeding (whether enterally or parenterally 5 ). These shifts result from hormonal and metabolic changes and may cause serious clinical complications.

What are the symptoms of hyperalimentation in refeeding syndrome?

Parasthesias, weakness, seizures, and hypophosphatemia in patients receiving hyperalimentation. Gastroenterology 1972;62:513-20. [ PubMed] [ Google Scholar] 12. Weinsier RL, Krumdieck CL. Death resulting from overzealous total parenteral nutrition: the refeeding syndrome revisited. Am J Clin Nutr 1980;34:393-9. [ PubMed] [ Google Scholar] 13.

Who is at high risk for refeeding syndrome?

High risk patients include those who have been chronically undernourished, especially those who also have diminished physiological reserve. Patients with dysphagia (for example, as a result of stroke) in particular may be at high risk. figure summarises how to prevent and treat refeeding syndrome.