Refeeding Syndrome in the Critically Ill: a Literature Review and Clinician's Guide

Curr Gastroenterol Rep. 2019 Nov 22;21(11):58. doi: 10.1007/s11894-019-0724-3.


Purpose of review: To provide an overview of current methods of diagnosis and management of refeeding syndrome in the critically ill patient population.

Recent findings: Despite recent publications indicating refeeding syndrome (RFS) is an ongoing problem in critically ill patients, there is no standard for the diagnosis and management of this life-threatening condition. There is not a "gold standard" nutrition assessment tool for the critically ill. Currently, the National Institute for Health and Clinical Excellence criteria represent the best clinical assessment tool for RFS. Diagnosis and management with the help of a multidisciplinary metabolic team can decrease morbidity and mortality. Although a universal definition of RFS has yet to be defined, the diagnosis is made in patients with moderate to severe malnutrition who develop electrolyte imbalance after beginning nutritional support. The imbalances potentially can lead to cardiac, pulmonary, and gastrointestinal complications and failure. Standardizing a multidisciplinary nutrition care plan and formulating a protocol for critically ill patients who develop RFS can potentially decrease complication rates and overall mortality.

Keywords: Enteral; Gastrointestinal; Hypophosphatemia; Malnutrition; Parenteral; Refeeding syndrome.

Publication types

  • Review

MeSH terms

  • Critical Illness / therapy*
  • Enteral Nutrition
  • Humans
  • Nutrition Assessment
  • Parenteral Nutrition
  • Refeeding Syndrome / diagnosis*
  • Refeeding Syndrome / etiology
  • Refeeding Syndrome / physiopathology
  • Refeeding Syndrome / therapy*
  • Risk Factors
  • Treatment Outcome