Refeeding syndrome in Southeastern Taiwan: Our experience with 11 cases

Table 1 Criteria for determining people at high risk of developing refeeding syndrome (according to National Institute for Health and Clinical Excellence guidelines)

The patient has one or more of the following:

Body mass index less than 16 kg/m2

Unintentional weight loss greater than 15% within the last 3-6 mo

Little or no nutritional intake for more than 10 d

Low levels of potassium, phosphate or magnesium prior to feeding

Or the patient has two or more of the following:

Body mass index less than 18.5 kg/m2

Unintentional weight loss greater than 10% within the last 3-6 mo

Little or no nutritional intake for more than 5 d

A history of alcohol abuse or drugs including insulin, chemotherapy, antacids or diuretics

Table 2 Demographic and nutritional characteristics of patients with RFS at the beginning of nutrition support

	Mean ± SD
Number	11
Mean admission days	19.1 ± 8.5
Post-NG feeding days with nutrition consultation	5.0 ± 3.0
Sex (M/F)	7/4
Age (yr)	67.9 ± 19.3
Mean height (cm)	157.8 ± 10.1
Body mass index (kg/m2)	16.7 ± 3.8
Ideal weight (kg)	55.7 ± 7.7
BEE (kcal)	1012.7 ± 222.2
Leg edema (yes/no)	9/2
Diarrhea (yes/no)	7/4
Abdominal distension (yes/no)	4/7

NG: Nasogastric.

Table 3 Diet differences at initial presentation and after consultation

	Initial status	After nutritional consultation
Calorie (kcal)	1355.1 ± 296.2	907.2 ± 117.9a
Calorie/kg (kcal)	33.8 ± 9.5	22.7 ± 3.9a
Protein (g)	47.3 ± 10.4	49 ± 8
Thiamine (mg)	2.0 ± 0.5	8.5 ± 6.2a
K (mg)	1260.4 ± 297.7	1615.9 ± 265a
P (mg)	660 ± 151.8	862.1 ± 105.5a
Ca (mg)	672.3 ± 147.3	908.4 ± 199.1a
Mg (mg)	262 ± 62.2	269.6 ± 25.9

^aP < 0.05 vs control (paired-sample t-test).

Table 4 Biochemical differences at initial presentation and after nutritional adjustment

	Initial	Nutrition consult
K (mmol/L)	3.6 ± 0.5	4.4 ± 0.8a
P (MG/DL)	2.4 ± 0.9	3.3 ± 0.6a
Ca (MG/DL)	7. 9 ± 0.7	8.1 ± 0.8
Mg (MG/DL)	1.9 ± 0.4	2.0 ± 0.3
Na (mmol/L)	135.8 ± 5.6	134.6 ± 5.7
Glucose (MG/DL)	122 ± 47	117 ± 38

^aP < 0.05 vs control (paired-sample t-test).