malnutrition and refeeding

what people are malnourished according to NICE guidelines?

- BMI <18.5

- unintentional weight loss >10% within 3-6 months

- BMI <20 AND unintentional weight loss >5% within 3-6 months

what people are at risk of malnourishment according to NICE guidelines?

- eaten little or nothing for more than 5 days and/or are likely to eat little or nothing for 5 days or longer

or

- a poor absorptive capacity

or

- high nutrient losses

or

- increased nutritional needs from causes such as catabolism

which criteria does a pt have to meet to be at high risk for refeeding syndrome?

1 or more of the following:

- BMI < 16

- unintentional weight loss >15% within the last 3-6 months

- little or no nutritional intake for >10 days

- low levels of potassium, phosphate or magnesium before feeding

OR 2 or more of the following:

- BMI <18.5

- unintentional weight loss >10% within the last 3-6 months

- little or no nutritional intake for more than 5 days

- history of alcohol abuse

- certain medication

what medication can put you at risk of refeeding syndrome?

- insulin

- chemotherapy

- antacids

- diuretics

what is the recommended prescription for those at high risk of refeeding syndrome?

start at 10kcal/kg/day increasing slowly to meet full needs by 4 to 7 days

what are the main clinical features of refeeding syndrome?

- hypophosphataemia

- hypomagnesaemia

- hypokalaemia

- increased sodium and water retention

what is refeeding syndrome?

adverse clinical and biochemical response to feeding in severely malnourished patients

what complications can refeeding syndrome lead to?

- cardiac arrhythmias

- cardiac failure

- respiratory failure