Stanga Z, Brunner A, Leuenberger M, Grimble R F, Shenkin A, Allison S P, Lobo D N
Department of Internal Medicine, University Hospital, Bern, Switzerland.
Eur J Clin Nutr. 2008 Jun;62(6):687-94. doi: 10.1038/sj.ejcn.1602854. Epub 2007 Aug 15.
The refeeding syndrome is a potentially lethal complication of refeeding in patients who are severely malnourished from whatever cause. Too rapid refeeding, particularly with carbohydrate may precipitate a number of metabolic and pathophysiological complications, which may adversely affect the cardiac, respiratory, haematological, hepatic and neuromuscular systems leading to clinical complications and even death. We aimed to review the development of the refeeding syndrome in a variety of situations and, from this and the literature, devise guidelines to prevent and treat the condition. We report seven cases illustrating different aspects of the refeeding syndrome and the measures used to treat it. The specific complications encountered, their physiological mechanisms, identification of patients at risk, and prevention and treatment are discussed. Each case developed one or more of the features of the refeeding syndrome including deficiencies and low plasma levels of potassium, phosphate, magnesium and thiamine combined with salt and water retention. These responded to specific interventions. In most cases, these abnormalities could have been anticipated and prevented. The main features of the refeeding syndrome are described with a protocol to anticipate, prevent and treat the condition in adults.
再喂养综合征是无论何种原因导致严重营养不良患者在重新进食时可能出现的一种潜在致命并发症。过快重新进食，尤其是摄入碳水化合物，可能引发一系列代谢和病理生理并发症，这些并发症可能对心脏、呼吸、血液、肝脏和神经肌肉系统产生不利影响，进而导致临床并发症甚至死亡。我们旨在回顾在各种情况下再喂养综合征的发生情况，并据此以及相关文献制定预防和治疗该病症的指南。我们报告了7例病例，阐述了再喂养综合征的不同方面以及所采用的治疗措施。文中讨论了所遇到的具体并发症、其生理机制、高危患者的识别以及预防和治疗方法。每个病例都出现了再喂养综合征的一个或多个特征，包括钾、磷、镁和硫胺素缺乏及血浆水平降低，同时伴有盐和水潴留。这些情况通过特定干预措施得到了改善。在大多数情况下，这些异常情况本可被预见并预防。本文描述了再喂养综合征的主要特征，并给出了针对成人患者预见、预防和治疗该病症的方案。
