Pathophysiology, Treatment, and Prevention of Fluid and Electrolyte Abnormalities During Refeeding Syndrome

Refeeding syndrome may occur after the reintroduction of carbohydrates in chronically malnourished or acutely hypermetabolic patients as a result of a rapid shift to glucose utilization as an energy source. Electrolyte abnormalities of phosphorus, potassium, and magnesium occur, leading to complications of various organ systems, and may result in death. Patients should be screened for risk factors of malnutrition to prevent refeeding syndrome. For those at risk, nutrition should be initiated and slowly advanced toward the patient's goal over several days. Electrolyte disturbances should be aggressively corrected.