Síndrome de realimentação: da fisiopatologia ao manejo

Alan Felipe Sakai; Natalia Costa da Costa

doi:10.23925/1984-4840.2018v20i2a2

Autores/as

Alan Felipe Sakai Hospital Israelita Albert Einstein – São Paulo (SP), Brasil.
Natalia Costa da Costa Hospital Municipal do Campo Limpo Dr. Fernando Mauro Pires da Rocha – São Paulo (SP), Brasil.

DOI:

https://doi.org/10.23925/1984-4840.2018v20i2a2

Palabras clave:

síndrome da realimentação, desnutrição, fisiopatologia, equipe de assistência ao paciente, resultado de tratamento

Resumen

A síndrome de realimentação é um problema crescente e de extrema importância clínica, infelizmente diagnosticada tardiamente (provavelmente por ser mal reconhecida ou compreendida). Vários estudos já tentaram avaliar sua incidência, porém com resultados bastante variados. Os processos fisiopatológicos incluem distúrbios de glicose e de equilíbrio de fluidos, além de distúrbios eletrolíticos que envolvem principalmente os íons intracelulares fosfato, potássio e magnésio. Apesar de ser potencialmente evitável, está associada à alta morbidade e mortalidade. As equipes multiprofissionais podem ajudar a fornecer aconselhamento e educação em sua prevenção, reconhecimento e tratamento. Diretrizes de tratamento devem ser estabelecidas para facilitar isso.

Descargas

Los datos de descargas todavía no están disponibles.

Métricas

Cargando métricas ...

Citas

Kraft MD, Btaiche IF, Sacks GS. Review of the refeeding syndrome. Nutr Clin Pract. 2005;20(6):625-33. https://doi.org/10.1177/0115426505020006625

Khan LU, Ahmed J, Khan S, MacFie J. Refeeding syndrome: a literature review. Gastroenterol Res Pract. 2010;2011. https://doi.org/10.1155/2011/410971

Schnitker MA, Mattman PE, Bliss TL. A clinical study of malnutrition in Japanese prisoners of war. Ann Intern Med. 1951;35(1):69-96.

Mehanna H, Nankivell PC, Moledina J, Travis J. Refeeding syndrome: awareness, prevention and management. Head Neck Oncol. 2009;1:4. https://doi.org/10.1186/1758-3284-1-4

Hearing S. Refeeding syndrome. BMJ. 2004;328(7445): 908-9. https://doi.org/10.1136/bmj.328.7445.908

McCray S, Walker S, Parrish CR. Much ado about refeeding. Pract Gastroenterol [Internet]. 2005[acesso em 28 fev. 2017];(1):26-44. Disponível em: https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2015/11/McCrayArticle-Jan-05.pdf

Knochel JP. The clinical status of hypophosphatemia: an update. N Engl J Med. 1985;313(7):447-9. https://doi.org/10.1056/NEJM198508153130711

Hill GL, Bradley JA, Smith RC, Smith AH, McCarthy ID, Oxby CB, et al. Changes in body weight and body protein with intravenous nutrition. J Parenter Enteral Nutr. 1979;3(4):215-8. https://doi.org/10.1177/014860717900300402

Klein CJ, Stanek GS, Wiles CE 3rd. Overfeeding macronutrients to critically ill adults: Metabolic complications. J Am Diet Assoc. 1998;98(7):795-806. https://doi.org/10.1016/S0002-8223(98)00179-5

Solomon R. The relationship between disorders of K+ and Mg+ homeostasis. Semin Nephrol. 1987;7(3):253-62.

Reuler JB, Girard DE, Cooney TG. Current concepts: Wernicke’s encephalopathy. NEJM. 1985;312(16):1035-9. https://doi.org/10.1056/NEJM198504183121606

Veverbrants E, Arky RA. Effects of fasting and refeeding: I. Studies on sodium, potassium and water excretion on a constant electrolyte and fluid intake. J Clin Endocrinol Metab. 1969;29(1):55-62. https://doi.org/10.1210/jcem-29-1-55

O’Connor LR, Wheeler WS, Bethune JE. Effect of hypophosphatemia on myocardial performance inman. N Engl J Med. 1977;297(17):901-3. https://doi.org/10.1056/NEJM197710272971702

Silvis SE, Paragas PD. Paresthesias, weakness, seizures, and hypophosphatemia in patients receiving hyperalimentation. Gastroenterology. 1972;62(4):513- 20. https://doi.org/10.1016/S0016-5085(72)80032-5

Fernández López MT, López Otero MJ, Álvarez Vázquez P, Arias Delgado J, Varela Correa JJ. Refeeding syndrome. Farm Hosp. 2009;33(4):183-93.

National Institute for Health and Clinical Excellence. Oral nutrition support, enteral tube feeding and parenteral nutrition: clinical guideline [Internet]. 2006 [atualizado em 24 maio 2014; acesso em 12 ago. 2014]. Disponível em: https://www.nice.org.uk/Guidance/cg32

Mehanna HM, Moledina J, Travis J. Refeeding syndrome: what it is, and how to prevent and treat it. BMJ. 2008;336(7659):1495-8. https://doi.org/10.1136/bmj.a301

Rio A, Whelan K, Goff L, Reidlinger DP, Smeeton N. Occurrence of refeeding syndrome in adults started on artificial nutrition support: prospective cohort study. BMJ Open. 2013;3:e 002173. https://doi.org/10.1136/ bmjopen-2012-002173

Zeki S, Culkin A, Gabe SM, Nightingale JM. Refeeding hypophosphataemia is more common in enteral than parenteral feeding in adult in patients. Clin Nutr. 2011;30(3):365-8. https://doi.org/10.1016/j.clnu.2010.12.001

Dewar H, Horvath R. Refeeding syndrome guidelines. Oxford: Department of Nutrition and Dietetics, Oxford Radcliffe Hospital; 2000.