Lo Gullo Alberto, Rifici Carmela, Caliri Santina, Donato Antonina, De Cola Maria Cristina, Di Cara Marcella, Corallo Francesco, Bramanti Placido, Giuffrida Clemente
IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy.
J Int Med Res. 2021 Feb;49(2):300060520986675. doi: 10.1177/0300060520986675.
Refeeding syndrome can occur in malnourished patients with acute pancreatitis who have electrolyte imbalances. Refeeding syndrome is characterized by severe electrolyte imbalances (mainly hypophosphatemia, hypomagnesemia, and hypokalemia), vitamin deficiency (mainly thiamine deficiency), fluid overload, and salt retention resulting in organ dysfunction and cardiac arrhythmias. We herein report a case involving a patient with severe pancreatitis and gallbladder stones who developed refeeding syndrome with shock and loss of consciousness. The patient was treated by opportune vitamin and electrolyte supplementation therapy and showed substantial improvement after 2 weeks of hospitalization, gaining the ability to eat small bites of solid food orally. Early diagnosis and treatment of refeeding syndrome may reduce morbidity and mortality in patients with acute pancreatitis. Patients should be fasted only if alimentation is contraindicated, and electrolyte values must be closely monitored.
再喂养综合征可发生于患有急性胰腺炎且伴有电解质失衡的营养不良患者。再喂养综合征的特征为严重的电解质失衡(主要是低磷血症、低镁血症和低钾血症)、维生素缺乏(主要是硫胺素缺乏)、液体超负荷以及钠潴留,进而导致器官功能障碍和心律失常。我们在此报告一例涉及重症胰腺炎和胆结石患者的病例,该患者出现了伴有休克和意识丧失的再喂养综合征。通过适时补充维生素和电解质进行治疗,患者在住院2周后有显著改善,能够经口少量进食固体食物。早期诊断和治疗再喂养综合征可降低急性胰腺炎患者的发病率和死亡率。仅在营养支持禁忌时患者才应禁食,并且必须密切监测电解质值。