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再喂养综合征:临床及营养相关性

Refeeding syndrome: clinical and nutritional relevance.

作者信息

Viana Larissa de Andrade, Burgos Maria Goretti Pessoa de Araújo, Silva Rafaella de Andrade

机构信息

Departamento de Nutrição, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil.

出版信息

Arq Bras Cir Dig. 2012 Jan-Mar;25(1):56-9. doi: 10.1590/s0102-67202012000100013.

Abstract

INTRODUCTION

Feedback syndrome is characterized clinically by neurological alterations, respiratory symptoms, arrhythmias and heart failure few days after refeeding. It happens due to severe electrolyte changes, such as hypophosphatemia, hypomagnesemia and hypokalemia associated with metabolic abnormalities that may occur as a result of nutritional support (oral, enteral or parenteral) in severely malnourished patients.

OBJECTIVE

To evaluate its causes and the preventive dietary measures aiming to reduce the morbimortality.

METHODS

Was conducted literature review in SciELO, LILACS, Medline / PUBMED, Cochrane Library and government websites in Portuguese, English and Spanish. The survey was about the last 15 years, selecting the headings: refeeding syndrome, malnutrition, hypophosphatemia, hypokalemia, hypomagnesemia.

CONCLUSION

The monitoring of metabolic parameters and electrolyte levels before starting nutritional support and periodically during feeding should be based on protocols and the duration of therapy. Patients at high risk and other metabolic complications should be followed closely, and depletion of minerals and electrolytes should be replaced before starting the diet. A multidisciplinary team of nutrition therapy can guide and educate other health professionals in prevention, diagnosis and treatment of the syndrome.

摘要

引言

再喂养综合征的临床特征为在重新喂养几天后出现神经功能改变、呼吸道症状、心律失常和心力衰竭。其发生是由于严重的电解质变化,如低磷血症、低镁血症和低钾血症,这些与严重营养不良患者因营养支持(口服、肠内或肠外)可能出现的代谢异常有关。

目的

评估其病因以及旨在降低发病率和死亡率的预防性饮食措施。

方法

在科学电子图书馆在线(SciELO)、拉丁美洲和加勒比卫生科学数据库(LILACS)、医学在线数据库/医学期刊数据库(Medline / PUBMED)、考克兰图书馆以及葡萄牙语、英语和西班牙语的政府网站上进行文献综述。调查时间范围为过去15年,选择的标题为:再喂养综合征、营养不良、低磷血症、低钾血症、低镁血症。

结论

在开始营养支持前以及喂养期间定期监测代谢参数和电解质水平应依据方案和治疗持续时间进行。高危患者和其他代谢并发症患者应密切随访,在开始饮食前应补充矿物质和电解质的缺乏。营养治疗多学科团队可以在该综合征的预防、诊断和治疗方面指导和教育其他卫生专业人员。

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