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Refeeding Syndrome in the Critically Ill: a Literature Review and Clinician’s Guide

  • McKnight, C. L.1
  • Newberry, C.2
  • Sarav, M.3
  • Martindale, R.4
  • Hurt, R.5
  • Daley, B.6
  • 1 University of Tennessee-Knoxville, 1924 Alcoa Highway Box U-11, Knoxville, TN, 37920, USA , Knoxville (United States)
  • 2 Weill Cornell Medical Center, 1283 York Avenue, 9th Floor, New York, NY, 10065, USA , New York (United States)
  • 3 NorthShore University Health Systems, University of Chicago, Chicago, USA , Chicago (United States)
  • 4 Oregon Health Science University, 3303 SW Bond Ave Fl 6, Portland, OR, 97239, USA , Portland (United States)
  • 5 Mayo Clinic, Rochester, MN, USA , Rochester (United States)
  • 6 University of Tennessee Graduate School of Medicine, 1924 Alcoa Highway Box U-11, Knoxville, TN, 37920, USA , Knoxville (United States)
Published Article
Current Gastroenterology Reports
Springer US
Publication Date
Nov 22, 2019
DOI: 10.1007/s11894-019-0724-3
Springer Nature


Purpose of ReviewTo provide an overview of current methods of diagnosis and management of refeeding syndrome in the critically ill patient population.Recent FindingsDespite recent publications indicating refeeding syndrome (RFS) is an ongoing problem in critically ill patients, there is no standard for the diagnosis and management of this life-threatening condition. There is not a “gold standard” nutrition assessment tool for the critically ill. Currently, the National Institute for Health and Clinical Excellence criteria represent the best clinical assessment tool for RFS. Diagnosis and management with the help of a multidisciplinary metabolic team can decrease morbidity and mortality.SummaryAlthough a universal definition of RFS has yet to be defined, the diagnosis is made in patients with moderate to severe malnutrition who develop electrolyte imbalance after beginning nutritional support. The imbalances potentially can lead to cardiac, pulmonary, and gastrointestinal complications and failure. Standardizing a multidisciplinary nutrition care plan and formulating a protocol for critically ill patients who develop RFS can potentially decrease complication rates and overall mortality.

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