Elsevier

Clinical Nutrition

Volume 21, Issue 6, December 2002, Pages 515-520
Clinical Nutrition

Regular Article
Refeeding syndrome with enteral nutrition in children: a case report, literature review and clinical guidelines

https://doi.org/10.1054/clnu.2002.0586Get rights and content

Abstract

Refeeding syndrome is a potentially fatal complication of the nutritional management of severely malnourished patients. The syndrome almost always develops during the early stages of refeeding. It can be associated with a severe derangement in electrolyte and fluid balance, and result in significant morbidity and mortality. It is most often reported in adults receiving total parenteral nutrition (TPN), although refeeding with enteral feeds can also precipitate this syndrome.

We report what we believe to be the first case of refeeding syndrome in an adolescent with newly diagnosed Crohn's disease. This developed within a few days of starting exclusive polymeric enteral nutrition.

A systematic literature review revealed 27 children who developed refeeding syndrome after oral/enteral feeding. Of these, nine died as a direct result of complications of this syndrome. We discuss the implications of this syndrome on clinical practice and propose evidence-based guidelines for its management.

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    (Correspondence to: NAA, Centre for Pediatric Gastroenterology, Royal Free Hospital, Pond Street, Hampstead, London, NW3 2QG, UK)

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