IBCC Episode 83 - Refeeding Syndrome

In this episode of The Internet Book of Critical Care Podcast, Josh and Adam discuss refeeding syndrome, a potentially fatal condition that can occur when starved patients are rapidly refed. They cover the basics of the syndrome, including its pathophysiology, epidemiology, risk factors (such as psychosocial problems, gastrointestinal issues, and iatrogenic causes like prolonged NPO status), signs and symptoms (cardiovascular, neurologic, and abdominal), and lab abnormalities (hypophosphatemia, hypokalemia, hypomagnesemia). The hosts emphasize prevention strategies like checking electrolytes, administering thiamine, and initiating nutrition slowly with a focus on protein while limiting carbohydrates. They also discuss the clinical definition of refeeding syndrome and its treatment, including micronutrient supplementation, electrolyte repletion, careful nutritional support, and glycemic control. The key takeaway is the importance of being aware of refeeding syndrome and considering it in at-risk patients to avoid missing the diagnosis.