Department of Nutrition & Dietetics, Royal Free Hospital, London, UK.
J Hum Nutr Diet. 2011 Oct;24(5):505-15. doi: 10.1111/j.1365-277X.2011.01196.x.
The physiology and consequences of refeeding syndrome have long been recognised, although its management continues to be debated, despite the recommendations made by The National Institute for Health and Clinical Excellence (NICE) in their guideline 'Nutrition Support in Adults' (2006). The present study aims to assess current dietetic opinion and practice in this area, as well as whether the NICE recommendations have been adopted.
An anonymous, self-completed Internet survey was designed investigating current practice and opinions on the NICE (2006) guidance on this subject. A link to the questionnaire was distributed with a covering letter via e-mail to the heads of department of National Health Service Trusts in the London region, UK, requesting that it be disseminated to all dietitians working with adults. After the closing date, all responses were collated and analysed.
The survey elicited a 30.8% response rate. Some 89.8% of respondents have read the NICE guidance on Nutrition Support in Adults (2006) and 66.9% have changed their practice regarding refeeding syndrome management as a result. Sixty-two percent do not wait for biochemistry to normalise before commencing nutrition. Ninety-two percent of respondents completed the mini case studies indicating that current practice is inconsistent among dietitians. Neither NICE criteria for recognising patients at risk of refeeding, nor the recommended starting rates are universally followed. Seventy-five percent continue to supplement electrolytes reactively.
Although limited by a small sample size, the findings of the present study suggest that dietetic practice regarding refeeding syndrome management remains inconsistent with the recommendations made by NICE, although some aspects have been adopted.
尽管《英国国家卫生与临床优化研究所（NICE）成人营养支持指南（2006 年）》提出了相关建议，但人们早已认识到再喂养综合征的生理学和后果，且其管理仍存在争议。本研究旨在评估该领域当前的营养学意见和实践，以及是否采用了 NICE 建议。
设计了一项匿名、自我完成的互联网调查，旨在调查当前在该主题上对 NICE（2006 年）指南的实践和意见。通过电子邮件向英国伦敦地区国民保健署信托基金的部门主管发送了一封附有附信的问卷链接，要求他们将其分发给所有与成人一起工作的营养师。截止日期后，将所有回复进行了整理和分析。
该调查的回复率为 30.8%。89.8%的受访者阅读了 NICE 关于成人营养支持指南（2006 年），并因此改变了再喂养综合征管理方面的实践。62%的人在等待生化指标正常化之前就开始进行营养治疗。92%的受访者完成了迷你案例研究，表明营养师的当前实践不一致。既没有遵循 NICE 用于识别有再喂养风险患者的标准，也没有遵循推荐的起始率。75%的人继续反应性地补充电解质。
尽管本研究样本量较小，但研究结果表明，尽管已经采用了一些方面，但在再喂养综合征管理方面，营养学实践仍与 NICE 建议不一致。
