Afzal N A, Addai S, Fagbemi A, Murch S, Thomson M, Heuschkel R
Centre for Paediatric Gastroenterology, Royal Free Hospital, Hampstead, London, UK.
Clin Nutr. 2002 Dec;21(6):515-20. doi: 10.1054/clnu.2002.0586.
Refeeding syndrome is a potentially fatal complication of the nutritional management of severely malnourished patients. The syndrome almost always develops during the early stages of refeeding. It can be associated with a severe derangement in electrolyte and fluid balance, and result in significant morbidity and mortality. It is most often reported in adults receiving total parenteral nutrition (TPN), although refeeding with enteral feeds can also precipitate this syndrome. We report what we believe to be the first case of refeeding syndrome in an adolescent with newly diagnosed Crohn's disease. This developed within a few days of starting exclusive polymeric enteral nutrition. A systematic literature review revealed 27 children who developed refeeding syndrome after oral/enteral feeding. Of these, nine died as a direct result of complications of this syndrome. We discuss the implications of this syndrome on clinical practice and propose evidence-based guidelines for its management.
再喂养综合征是严重营养不良患者营养管理中一种潜在的致命并发症。该综合征几乎总是在再喂养的早期阶段出现。它可能与电解质和液体平衡的严重紊乱相关，并导致显著的发病率和死亡率。虽然肠内喂养再喂养也可能引发该综合征，但最常报道于接受全胃肠外营养（TPN）的成年人。我们报告了我们认为是首例新诊断为克罗恩病的青少年发生再喂养综合征的病例。这是在开始完全使用聚合型肠内营养几天后出现的。一项系统的文献综述发现27例儿童在口服/肠内喂养后发生了再喂养综合征。其中，9例直接死于该综合征的并发症。我们讨论了该综合征对临床实践的影响，并提出了基于证据的管理指南。
