An unexpectedly high incidence of refeeding syndrome in patients with total parenteral nutrition in a reference university hospital
Refeeding syndrome occurs with the reintroduction of food after an individual has undergone a substantial period of malnutrition. The development of this condition is not uncommon but is neglected in most cases. To identify the incidence of refeeding syndrome in hospitalized patients undergoing tota...
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| Veröffentlicht in: | Clinical nutrition (Edinburgh, Scotland) Scotland), 2021-06, Vol.40 (6), p.3702-3707 |
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| container_title | Clinical nutrition (Edinburgh, Scotland) |
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| creator | de Vargas Cony, Karina de Magalhães Francesconi, Carlos Fernando |
| description | Refeeding syndrome occurs with the reintroduction of food after an individual has undergone a substantial period of malnutrition. The development of this condition is not uncommon but is neglected in most cases.
To identify the incidence of refeeding syndrome in hospitalized patients undergoing total parenteral nutrition and factors that may be associated with this condition.
Observational retrospective and prospective cohort study. Data collection took place at the Hospital de Clínicas de Porto Alegre, from 2015 to 2018. Data was collected consecutively from patient electronic medical records. All hospitalized individuals aged 18 years or more and having a prescription for total parenteral nutrition were included in the study. Exclusion criteria included patients with diabetic ketoacidosis; receiving renal replacement therapy or chronic kidney disease with a glomerular filtration rate |
| doi_str_mv | 10.1016/j.clnu.2021.04.016 |
| format | Article |
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To identify the incidence of refeeding syndrome in hospitalized patients undergoing total parenteral nutrition and factors that may be associated with this condition.
Observational retrospective and prospective cohort study. Data collection took place at the Hospital de Clínicas de Porto Alegre, from 2015 to 2018. Data was collected consecutively from patient electronic medical records. All hospitalized individuals aged 18 years or more and having a prescription for total parenteral nutrition were included in the study. Exclusion criteria included patients with diabetic ketoacidosis; receiving renal replacement therapy or chronic kidney disease with a glomerular filtration rate <30 mL/min; severe metabolic acidosis or any disease that could affect serum phosphorus levels. WinPepi software, version 11.65, was used to calculate sample size. Data analysis was performed using SPSS version 20.0. A 5% significance level was considered for the established comparisons. The project was approved by the Research Ethics Committee of Hospital de Clínicas de Porto Alegre (number 17–0313).
Data from 97 patients was collected. The incidence of refeeding syndrome in our sample was 43.3% (n = 42). Factors positively associated with the syndrome were use of standard parenteral nutrition (p < 0.01), advancing age (mean 62.8 yr versus 55.1 yr; p = 0.013), and amount of total energy administered, which were 25.6 kcal/kg/day versus 23.6 kcal/kg/day for patients with and without refeeding syndrome, respectively (p < 0.01).
The incidence of refeeding syndrome in individuals using total parenteral nutrition was high. The supply of a greater quantity of total energy in the first week of nutritional therapy, the absence of electrolytes in the parenteral nutrition solution and advancing age were all factors associated with the emergence of refeeding syndrome.</description><identifier>ISSN: 0261-5614</identifier><identifier>EISSN: 1532-1983</identifier><identifier>DOI: 10.1016/j.clnu.2021.04.016</identifier><identifier>PMID: 34130015</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Age Factors ; Aged ; Aged, 80 and over ; Cohort Studies ; Electrolyte imbalance ; Electrolytes ; Energy Intake ; Female ; Hospitals, University ; Humans ; Incidence ; Male ; Middle Aged ; Nutritional Status ; Parenteral nutrition ; Parenteral Nutrition, Total - methods ; Refeeding hypophosphatemia ; Refeeding syndrome ; Refeeding Syndrome - epidemiology</subject><ispartof>Clinical nutrition (Edinburgh, Scotland), 2021-06, Vol.40 (6), p.3702-3707</ispartof><rights>2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism</rights><rights>Copyright © 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-cc28b5d0f37540df68b775563612343e379b2121baa990f2574962632f03ec603</citedby><cites>FETCH-LOGICAL-c356t-cc28b5d0f37540df68b775563612343e379b2121baa990f2574962632f03ec603</cites><orcidid>0000-0003-4800-2905</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clnu.2021.04.016$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34130015$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Vargas Cony, Karina</creatorcontrib><creatorcontrib>de Magalhães Francesconi, Carlos Fernando</creatorcontrib><title>An unexpectedly high incidence of refeeding syndrome in patients with total parenteral nutrition in a reference university hospital</title><title>Clinical nutrition (Edinburgh, Scotland)</title><addtitle>Clin Nutr</addtitle><description>Refeeding syndrome occurs with the reintroduction of food after an individual has undergone a substantial period of malnutrition. The development of this condition is not uncommon but is neglected in most cases.
To identify the incidence of refeeding syndrome in hospitalized patients undergoing total parenteral nutrition and factors that may be associated with this condition.
Observational retrospective and prospective cohort study. Data collection took place at the Hospital de Clínicas de Porto Alegre, from 2015 to 2018. Data was collected consecutively from patient electronic medical records. All hospitalized individuals aged 18 years or more and having a prescription for total parenteral nutrition were included in the study. Exclusion criteria included patients with diabetic ketoacidosis; receiving renal replacement therapy or chronic kidney disease with a glomerular filtration rate <30 mL/min; severe metabolic acidosis or any disease that could affect serum phosphorus levels. WinPepi software, version 11.65, was used to calculate sample size. Data analysis was performed using SPSS version 20.0. A 5% significance level was considered for the established comparisons. The project was approved by the Research Ethics Committee of Hospital de Clínicas de Porto Alegre (number 17–0313).
Data from 97 patients was collected. The incidence of refeeding syndrome in our sample was 43.3% (n = 42). Factors positively associated with the syndrome were use of standard parenteral nutrition (p < 0.01), advancing age (mean 62.8 yr versus 55.1 yr; p = 0.013), and amount of total energy administered, which were 25.6 kcal/kg/day versus 23.6 kcal/kg/day for patients with and without refeeding syndrome, respectively (p < 0.01).
The incidence of refeeding syndrome in individuals using total parenteral nutrition was high. The supply of a greater quantity of total energy in the first week of nutritional therapy, the absence of electrolytes in the parenteral nutrition solution and advancing age were all factors associated with the emergence of refeeding syndrome.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cohort Studies</subject><subject>Electrolyte imbalance</subject><subject>Electrolytes</subject><subject>Energy Intake</subject><subject>Female</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nutritional Status</subject><subject>Parenteral nutrition</subject><subject>Parenteral Nutrition, Total - methods</subject><subject>Refeeding hypophosphatemia</subject><subject>Refeeding syndrome</subject><subject>Refeeding Syndrome - epidemiology</subject><issn>0261-5614</issn><issn>1532-1983</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtv1DAUhS0EotPCH2CBsmSTcP1MIrGpKh6VKrGBtZXYNx2PMnawncKs-eM4ncKSla1zzzn2_Qh5Q6GhQNX7Q2NmvzYMGG1ANEV6RnZUclbTvuPPyQ6YorVUVFyQy5QOACB5270kF1xQDkDljvy-9tXq8deCJqOdT9Xe3e8r542z6A1WYaoiTojW-fsqnbyN4YhlXi1Dduhzqn66vK9yyMNctFgkjOXq1xxddsFv3uGxIz4Wrt49YEwul6dCWlzJvSIvpmFO-PrpvCLfP338dvOlvvv6-fbm-q42XKpcG8O6UVqYeCsF2El1Y9tKqbiijAuOvO1HRhkdh6HvYWKyFb1iirMJOBoF_Iq8O_cuMfxYMWV9dMngPA8ew5o0k4K2nQAhipWdrSaGlMrv9RLdcYgnTUFv8PVBb_D1Bl-D0EUqobdP_et4RPsv8pd2MXw4G7Bs-eAw6mTcRsW6WPhrG9z_-v8AvZyXfQ</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>de Vargas Cony, Karina</creator><creator>de Magalhães Francesconi, Carlos Fernando</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4800-2905</orcidid></search><sort><creationdate>202106</creationdate><title>An unexpectedly high incidence of refeeding syndrome in patients with total parenteral nutrition in a reference university hospital</title><author>de Vargas Cony, Karina ; de Magalhães Francesconi, Carlos Fernando</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-cc28b5d0f37540df68b775563612343e379b2121baa990f2574962632f03ec603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cohort Studies</topic><topic>Electrolyte imbalance</topic><topic>Electrolytes</topic><topic>Energy Intake</topic><topic>Female</topic><topic>Hospitals, University</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nutritional Status</topic><topic>Parenteral nutrition</topic><topic>Parenteral Nutrition, Total - methods</topic><topic>Refeeding hypophosphatemia</topic><topic>Refeeding syndrome</topic><topic>Refeeding Syndrome - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Vargas Cony, Karina</creatorcontrib><creatorcontrib>de Magalhães Francesconi, Carlos Fernando</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Vargas Cony, Karina</au><au>de Magalhães Francesconi, Carlos Fernando</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An unexpectedly high incidence of refeeding syndrome in patients with total parenteral nutrition in a reference university hospital</atitle><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle><addtitle>Clin Nutr</addtitle><date>2021-06</date><risdate>2021</risdate><volume>40</volume><issue>6</issue><spage>3702</spage><epage>3707</epage><pages>3702-3707</pages><issn>0261-5614</issn><eissn>1532-1983</eissn><abstract>Refeeding syndrome occurs with the reintroduction of food after an individual has undergone a substantial period of malnutrition. The development of this condition is not uncommon but is neglected in most cases.
To identify the incidence of refeeding syndrome in hospitalized patients undergoing total parenteral nutrition and factors that may be associated with this condition.
Observational retrospective and prospective cohort study. Data collection took place at the Hospital de Clínicas de Porto Alegre, from 2015 to 2018. Data was collected consecutively from patient electronic medical records. All hospitalized individuals aged 18 years or more and having a prescription for total parenteral nutrition were included in the study. Exclusion criteria included patients with diabetic ketoacidosis; receiving renal replacement therapy or chronic kidney disease with a glomerular filtration rate <30 mL/min; severe metabolic acidosis or any disease that could affect serum phosphorus levels. WinPepi software, version 11.65, was used to calculate sample size. Data analysis was performed using SPSS version 20.0. A 5% significance level was considered for the established comparisons. The project was approved by the Research Ethics Committee of Hospital de Clínicas de Porto Alegre (number 17–0313).
Data from 97 patients was collected. The incidence of refeeding syndrome in our sample was 43.3% (n = 42). Factors positively associated with the syndrome were use of standard parenteral nutrition (p < 0.01), advancing age (mean 62.8 yr versus 55.1 yr; p = 0.013), and amount of total energy administered, which were 25.6 kcal/kg/day versus 23.6 kcal/kg/day for patients with and without refeeding syndrome, respectively (p < 0.01).
The incidence of refeeding syndrome in individuals using total parenteral nutrition was high. The supply of a greater quantity of total energy in the first week of nutritional therapy, the absence of electrolytes in the parenteral nutrition solution and advancing age were all factors associated with the emergence of refeeding syndrome.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>34130015</pmid><doi>10.1016/j.clnu.2021.04.016</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-4800-2905</orcidid></addata></record> |
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| ispartof | Clinical nutrition (Edinburgh, Scotland), 2021-06, Vol.40 (6), p.3702-3707 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adult Age Factors Aged Aged, 80 and over Cohort Studies Electrolyte imbalance Electrolytes Energy Intake Female Hospitals, University Humans Incidence Male Middle Aged Nutritional Status Parenteral nutrition Parenteral Nutrition, Total - methods Refeeding hypophosphatemia Refeeding syndrome Refeeding Syndrome - epidemiology |
| title | An unexpectedly high incidence of refeeding syndrome in patients with total parenteral nutrition in a reference university hospital |
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