Refeeding Syndrome and Hypophosphatemi

Marinella, Mark A. MD, FACP, FACN, CNSP

From Wright State University School of Medicine, Dayton, OH.

Address correspondence to Mark A. Marinella, MD, 33 West Rahn Rd., #101, Dayton, OH 45429, or e-mail: [email protected].

Received Aug 17, 2004, and in revised form Nov 29, 2004. Accepted for publication Dec 1, 2004.

Journal of Intensive Care Medicine 20(3):p 155-159, May-June 2005.

Hypophosphatemia is a potentially life-threatening complication of reinstating nutrition in a malnourished patient. Refeeding syndrome is a term that refers to various metabolic abnormalities that may complicate carbohydrate administration in subnourished patient populations. Hypophosphatemia is the most well-known, and perhaps most significant, element of the refeeding syndrome and may result in sudden death, rhabdomyolysis, red cell dysfunction, and respiratory insufficiency. This review briefly examines refeeding-induced hypophosphatemia in the hospitalized patient in hopes of making clinicians more aware of this common, but often overlooked, potentially dangerous problem.