Cormack et al reported risk factors associated with neonatal refeeding syndrome in a preterm neonate. This can help to identify a patient who may require more aggressive management. The authors are from University of Auckland and Auckland City Hospital in New Zealand.
Patient selection: preterm neonate
Criteria for neonatal refeeding syndrome - both of the following:
(1) serum phosphate < 1.4 mmol/L
(2) serum total calcium > 2.8 mmol/L
The neonate also tends to have low serum potassium and low serum magnesium concentrations.
Risk factors for the neonatal refeeding syndrome:
(1) extremely low-birth-weight (ELBW, with birthweight less than 1,000 g)
(2) high intravenous protein intake
(3) little or no intravenous phosphate intake
The risk of the refeeding syndrome decreased by 70% for each 1 mmol/kg/day of intravenous phosphate intake.
Development of the refeeding syndrome is associated with increased morbidity and mortality. The risk of intraventricular hemorrhage is increased.
