Description

Mehanna et al listed complications of the refeeding syndrome and the underlying causes. The authors are from University Hospital Coventry and the Heart of England Foundation Trust.


 

Causes for complications include:

(1) hypophosphatemia

(2) hypokalemia

(3) hypomagnesemia

(4) fluid intolerance

(5) glucose intolerance

(6) muscle wasting

(7) thiamine deficiency

 

Complications seen during refeeding may include:

(1) cardiac arrhythmia: 1, 2, 3, 4

(2) congestive heart failure (CHF): 1, 4

(3) cardiomyopathy: 1, 6

(4) impaired cardiac contractility: 1, 6

(5) altered blood pressure (hypotension or hypertension): 1, 2, 3

(6) tachycardia: 3

(7) cardiac arrest: 2

(8) digoxin toxicity: 2

(9) sudden death: 1, 2, 3, 4

(10) fluid overload: 4

(11) respiratory failure or ventilator dependency: 1, 6

(12) pulmonary edema: 2

(13) carbon dioxide retention: 2, 5

(14) fits

(15) weakness: 1, 2, 3

(16) paresthesias: 1, 3

(17) altered mental status: 1, 2, 3

(18) paralysis: 1, 2

(19) ataxia: 3

(20) tremor: 3

(21) vertigo: 3

(22) tetany: 3

(23) seizures: 1, 3

(24) Wernicke’s encephalopathy: 7

(25) Korsakoff’s syndrome: 7

(26) osmotic diuresis: 5

(27) prerenal azotemia: 5

(28) decreased ability of the renal tubules to concentrate urine: 2

(29) muscle weakness: 1, 2

(30) myalgia: 1,2

(31) rhabdomyolysis: 1, 2

(32) insulin resistance: 5

(33) osteomalacia

(34) platelet dysfunction: 1

(35) hemolytic anemia: 1

(36) leukocyte dysfunction: 1

(37) altered red blood cell morphology: 1

(38) anemia (nonhemolytic): 3

(39) reduced oxygen release from hyperbaric oxygen: 1

(40) metabolic alkalosis: 2

(41) glucose intolerance: 2, 5

(42) hyperglycemia: 2, 5

(43) hypernatremia: 2, 5

(44) ketoacidosis: 2, 5

(45) metabolic acidosis: 2, 5

(46) constipation: 2, 3

(47) paralytic ileus: 2

(48) abdominal pain: 3

(49) diarrhea: 3

(50) anorexia: 3

(51) fatty liver: 5

(52) dehydration: 5

(53) hypotension: 5

 

where:

• Several items (like weakness or glucose intolerance) are present more than once.

 


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