Kohn M R, Golden N H, Shenker I R
Department of Adolescent Medicine, Long Island Jewish Hospital, Albert Einstein College of Medicine, New York, New York, USA.
J Adolesc Health. 1998 Mar;22(3):239-43. doi: 10.1016/S1054-139X(97)00163-8.
To describe the clinical presentation of the refeeding syndrome and highlight the dangers of performing nutritional rehabilitation too rapidly in a severely malnourished patient.
Retrospective case review of adolescents admitted with anorexia nervosa who developed the refeeding syndrome.
Between July 1993 and July 1994, 3 of 48 adolescent females developed the refeeding syndrome. While the cardiac complications occurred in the first week of refeeding, the delirium characteristic of this syndrome occurred later and was more variably related to hypophosphatemia.
Refeeding malnourished patients with anorexia nervosa can be associated with hypophosphatemia, cardiac arrhythmia and delirium. Refeeding patients with anorexia nervosa who are < 70% of ideal body weight should proceed with caution, and the caloric prescription should be increased gradually. Supplemental phosphorus should be commenced early and serum levels maintained above 3.0 mg/dL. Cardiac and neurologic events associated with refeeding are most likely to occur within the first weeks, justifying close monitoring of electrolyte and cardiac status.
描述再喂养综合征的临床表现，并强调在严重营养不良患者中过快进行营养康复的危险性。
对患再喂养综合征的神经性厌食症住院青少年患者进行回顾性病例分析。
1993年7月至1994年7月期间，48例青春期女性中有3例出现再喂养综合征。心脏并发症在再喂养的第一周出现，而该综合征特有的谵妄出现较晚，且与低磷血症的关系更为多变。
对神经性厌食症的营养不良患者进行再喂养可能会导致低磷血症、心律失常和谵妄。对体重低于理想体重70%的神经性厌食症患者进行再喂养时应谨慎，热量处方应逐渐增加。应尽早开始补充磷，并将血清水平维持在3.0mg/dL以上。与再喂养相关的心脏和神经事件最有可能在最初几周内发生，因此有必要密切监测电解质和心脏状况。
