Retrospective Study
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World J Gastroenterol. Aug 14, 2014; 20(30): 10525-10530
Published online Aug 14, 2014. doi: 10.3748/wjg.v20.i30.10525
Refeeding syndrome in Southeastern Taiwan: Our experience with 11 cases
Li-Ju Chen, Huan-Lin Chen, Ming-Jong Bair, Chia-Hsien Wu, I-Tsung Lin, Yuan-Kai Lee, Cheng-Hsin Chu
Li-Ju Chen, Department of Nutrition, Mackay Memorial Hospital, Taitung 91202, Taiwan
Huan-Lin Chen, Ming-Jong Bair, Chia-Hsien Wu, I-Tsung Lin, Yuan-Kai Lee, Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung 91202, Taiwan
Huan-Lin Chen, Department of Pharmacy and Graduate Institute of Pharmaceutical Technology, Tajen University, Taitung 90741, Taiwan
Ming-Jong Bair, Department of Nursing, Meiho University, Taitung 91202, Taiwan
Cheng-Hsin Chu, Department of Nutrition and Gastroenterology, Mackay Memorial Hospital, Taipei 10449, Taiwan
Cheng-Hsin Chu, Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 10449, Taiwan
Cheng-Hsin Chu, Mackay Junior College of Medicine, Nursing, and Management College, Taipei 10449, Taiwan
Author contributions: Chen LJ, Chen HL, Bair MJ, Wu CH, Lin IT, Lee YK and Chu CH contributed to the manuscript.
Correspondence to: Dr. Cheng-Hsin Chu, Department of Nutrition and Gastroenterology, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Taipei 10449, Taiwan. mmh4071@gmail.com
Telephone: +886-2-25433535 Fax: +886-2-25433535-3993
Received: December 30, 2013
Revised: March 13, 2014
Accepted: May 1, 2014
Published online: August 14, 2014
Processing time: 231 Days and 16.4 Hours
Abstract

AIM: To present our experience with refeeding syndrome in southeastern Taiwan.

METHODS: We conducted a retrospective study during a 2-year period at the Mackay Memorial Hospital, Taitung Branch. We enrolled patients with very little or no nutrition intake for more than 10 d, a high risk group of refeeding syndrome, including those suffering from alcohol abuse, cancerous cachexia, chronic malnutrition, and prolonged starvation.

RESULTS: A total of 11 patients (7 males, 4 females) with nasogastric feeding were included as having refeeding syndrome. Most of them had the symptoms of diarrhea, lethargy, and leg edema. The initial nutritional supplement was found to be relatively high in calories (1355.1 ± 296.2 kcal/d), high in protein (47.3 ± 10.4 gm/d), low in vitamin B1 (2.0 ± 0.5 mg/d), low in potassium (1260.4 ± 297.7 mg/d), and low in phosphorus (660.1 ± 151.8 mg/d). Furthermore, hypophosphatemia (2.4 ± 0.9 mg/dL) was noted during follow-up. Based on the suggestions of a dietician and a gastroenterologist, the clinical disorders of diarrhea, malaise and leg edema were significantly improved. The level of phosphate was also increased (3.3 ± 0.6 mg/dL).

CONCLUSION: Refeeding syndrome is an overlooked and risky disorder that has some potentially fatal complications. Nasogastric feeding in nursing homes is an important risk factor for patients and deserves greater attention based on the initial results of this study.

Keywords: Refeeding syndrome; Nutrition status; Cachexia; Hypophosphatemia; Risk assessment