Mouillot T, Brindisi M-C, Chambrier C, Audia S, Brondel L
Service d'hépato-gastro-entérologie, CHU F.-Mitterrand, 21000 Dijon, France; AgroSup Dijon, CNRS, Inrae, centre des sciences du goût et de l'alimentation, université Bourgogne Franche-Comté, 21000 Dijon, France.
AgroSup Dijon, CNRS, Inrae, centre des sciences du goût et de l'alimentation, université Bourgogne Franche-Comté, 21000 Dijon, France; Service d'endocrinologie et diabétologie, CHU F.-Mitterrand, 21000 Dijon, France.
Rev Med Interne. 2021 May;42(5):346-354. doi: 10.1016/j.revmed.2020.12.012. Epub 2021 Feb 3.
Refeeding syndrome (RS) is a rare but severe condition that is poorly understood, often under-diagnosed and can lead to death. It occurs within 5 days after refeeding in patients after prolonged fasting or in a context of undernutrition. As a consequence of the abrupt transition from catabolism to anabolism, RS is defined as a decrease in plasma levels of phosphorus, potassium and/or magnesium, whether or not associated with organ dysfunction resulting from a decrease in one of the electrolytes or a thiamine deficiency, after refeeding. The clinical symptoms are varied and non-specific and are related to hydro electrolyte disorders, sodium-hydroxide retention or failure of one or more organs. Patient management should be appropriate with regular clinical examination and careful biological monitoring, including hydro electrolyte monitoring. The correction of hydroelectrolytic disorders and systematic thiamine supplementation are essential during refeeding, that must be done carefully and very progressively, whatever its form (oral, enteral or parenteral). The severity of the refeeding syndrome indicates that its prevention and screening are the corners of its management in at-risk patients.
再喂养综合征(RS)是一种罕见但严重的病症,人们对其了解甚少,常常诊断不足,且可能导致死亡。它发生在长期禁食后的患者重新进食后5天内或处于营养不良的情况下。由于从分解代谢突然转变为合成代谢,再喂养综合征被定义为重新进食后血浆中磷、钾和/或镁水平降低,无论是否伴有因一种电解质减少或硫胺素缺乏导致的器官功能障碍。其临床症状多样且无特异性,与水电解质紊乱、钠潴留或一个或多个器官功能衰竭有关。患者管理应适当,进行定期临床检查和仔细的生物学监测,包括水电解质监测。在重新进食期间,纠正水电解质紊乱和系统性补充硫胺素至关重要,无论采用何种形式(口服、肠内或肠外),都必须谨慎且非常缓慢地进行。再喂养综合征的严重性表明,对高危患者进行预防和筛查是其管理的关键。