Clinical Features of Refeeding Syndrome

 

Clinical manifestations that may appear within hours or days of starting nutritional intake by any route:

(1) heart failure

(2) hypotension

(3) cardiac arrhythmias

(4) respiratory failure

(5) rhabdomyolysis

(6) hemolytic anemia

(7) seizures

(8) coma

(9) sudden death

 

Underlying chemical deficiencies:

(1) marked reduction in total body phosphate stores. Serum levels may be within the normal reference range when the patient first presents, but severe hypophosphatemia (serum levels < 0.50 mmol/L) develops 2-4 days after nutrition is restarted.

(2) hypomagnesemia

(3) hypokalemia

(4) thiamine and other vitamin deficiencies

(5) protein malnutrition

 

The patient can die suddenly if the condition is not recognized promptly and therapy started.