Lambers Wietske M, Kraaijenbrink Bastiaan, Siegert Carl E H
Sint Lucas Andreas Ziekenhuis, afd. Interne geneeskunde, Amsterdam.
Ned Tijdschr Geneeskd. 2015;159:A8610.
The refeeding syndrome may occur during reintroduction of carbohydrates in malnourished patients. This syndrome is characterized by reduced plasma electrolyte levels, hypophosphataemia being most prevalent. The symptoms can vary from minor symptoms to severe neurological or cardiac symptoms. The pathophysiological mechanism comprises an increase in insulin levels, resulting in shifts of phosphate, potassium and magnesium into the intracellular environment, as well as fluid retention and relative deficiency of vitamin B1. There is growing interest in the screening and treatment of patients with malnutrition, due to which the incidence of refeeding syndrome is probably increasing. Currently, there is no single definition of this syndrome and therefore there is no solid scientific basis for screening and treatment. In this article we describe the rationale for screening and additional laboratory investigations. A prospective, controlled trial is important to define the clinical relevance of the refeeding syndrome and optimize its treatment.
再喂养综合征可能发生在营养不良患者重新摄入碳水化合物的过程中。该综合征的特征是血浆电解质水平降低，其中低磷血症最为常见。症状可从轻微症状到严重的神经或心脏症状不等。其病理生理机制包括胰岛素水平升高，导致磷酸盐、钾和镁向细胞内环境转移，以及液体潴留和维生素B1相对缺乏。由于对营养不良患者的筛查和治疗越来越受到关注，再喂养综合征的发病率可能正在上升。目前，对于该综合征尚无统一的定义，因此筛查和治疗缺乏坚实的科学依据。在本文中，我们描述了筛查的基本原理以及额外的实验室检查。一项前瞻性对照试验对于明确再喂养综合征的临床相关性并优化其治疗至关重要。
