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Refeeding syndrome prevention — ESEGH MCQ

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HardNutritionRefeeding syndrome preventionESEGH

A 48-year-old man with alcohol dependence is admitted after 10 days of minimal intake. BMI is 17 kg/m2 and he has lost 12% body weight over 3 months. Phosphate is 0.52 mmol/L, potassium 3.1 mmol/L and magnesium 0.55 mmol/L. Enteral feeding is planned. What is the most appropriate management?

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Correct answer: A — Give thiamine, replace electrolytes and start nutrition cautiously

He is at high risk of refeeding syndrome, so thiamine, electrolyte correction and cautious calorie introduction are required. Full-calorie feeding can precipitate arrhythmia, heart failure and neurological harm. Withholding nutrition for a week worsens malnutrition. The pearl is that phosphate, potassium and magnesium must be anticipated and monitored during refeeding.

Reference: NICE Nutrition Support Guideline CG32