Ignite Creation Date:
2024-10-26 @ 3:39 PM
Last Modification Date:
2024-10-26 @ 3:39 PM
Study NCT ID:
NCT06583928
Status:
NOT_YET_RECRUITING
Last Update Posted:
None
First Post:
2024-08-31
Brief Title:
Refeeding Syndrome in Critically Ill Children
Sponsor:
None
Organization:
None
Study Overview
Official Title:
Frequency of Refeeding Syndrome in Critically Ill Children At Assiut University Hospital
Status:
NOT_YET_RECRUITING
Status Verified Date:
2024-09
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
No
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Refeeding syndrome RFS is the a metabolic disturbance which occurs as a result of reinstitution of nutrition in people who are starved severely malnourished or metabolically stressed because of severe illness When too much food or liquid nutrition supplement is eaten during the initial three to seven days following a malnutrition event the production of glycogen fat and protein in cells may cause low serum concentrations of potassium magnesium and phosphate
Detailed Description:
Refeeding syndrome RFS is the a metabolic disturbance which occurs as a result of reinstitution of nutrition in people who are starved severely malnourished or metabolically stressed because of severe illness When too much food or liquid nutrition supplement is eaten during the initial three to seven days following a malnutrition event the production of glycogen fat and protein in cells may cause low serum concentrations of potassium magnesium and phosphate
When risk factors are not identified and nutrition therapy is not managed appropriately devastating consequences such as electrolyte depletion and imbalances fluid overload arrhythmia seizure encephalopathy and death may occur
Once nutrition is reintroduced to a patient who has been starved for an extended period anabolism begins directly The body shifts back to carbohydrate metabolism from protein and fat catabolism and glucose becomes the primary source of energy once again The increased glucose load with a corresponding increase in the release of insulin leads to cellular uptake of glucose potassium magnesiumand phosphate This shift of electrolytes back into the cell causeshypokalemiahypomagnesemia and hypophosphatemia Insulin also exhibits a natriuretic effect on the kidneys Hence sodium is retained causing fluid retention and expansion of the extracellular fluid volume
Hypophosphatemia is the hallmark of RFS Other electrolyte abnormalities are associated with RFS however such as hypokalemia and hypomagnesemia Shifts in glucose sodium and fluid balance are also seen in RFS Consequently cardiovascular pulmonary neuromuscular hematologic and gastrointestinal complications occur
This syndrome can emerge with aggressive oral nutrition enteral nutrition or PN and can be fatal if not recognized and treated in a timely manner
Refeeding syndrome can be fatal if not recognized and treated properly The electrolyte disturbances of the refeeding syndrome can occur within the first few days of refeeding Close monitoring of blood biochemistry is therefore necessary in the early refeeding period
A Data on RFS incidence is lacking and the heterogeneity of diagnostic criteria and frequent electrolyte disorders in this population make its diagnosis complex In 2020 the American Society for Parenteral and Enteral Nutrition ASPEN developed consensus recommendations for identifying patients at risk and with refeeding syndrome These state that undernourished children are considered at risk of refeeding syndrome those who develop one significant electrolyte disorder decrease 10 in phosphorus potassium andor magnesium within the first five days of nutritional support combined with a significant increase in energy intake are considered to have refeeding syndrome
When risk factors are not identified and nutrition therapy is not managed appropriately devastating consequences such as electrolyte depletion and imbalances fluid overload arrhythmia seizure encephalopathy and death may occur
Once nutrition is reintroduced to a patient who has been starved for an extended period anabolism begins directly The body shifts back to carbohydrate metabolism from protein and fat catabolism and glucose becomes the primary source of energy once again The increased glucose load with a corresponding increase in the release of insulin leads to cellular uptake of glucose potassium magnesiumand phosphate This shift of electrolytes back into the cell causeshypokalemiahypomagnesemia and hypophosphatemia Insulin also exhibits a natriuretic effect on the kidneys Hence sodium is retained causing fluid retention and expansion of the extracellular fluid volume
Hypophosphatemia is the hallmark of RFS Other electrolyte abnormalities are associated with RFS however such as hypokalemia and hypomagnesemia Shifts in glucose sodium and fluid balance are also seen in RFS Consequently cardiovascular pulmonary neuromuscular hematologic and gastrointestinal complications occur
This syndrome can emerge with aggressive oral nutrition enteral nutrition or PN and can be fatal if not recognized and treated in a timely manner
Refeeding syndrome can be fatal if not recognized and treated properly The electrolyte disturbances of the refeeding syndrome can occur within the first few days of refeeding Close monitoring of blood biochemistry is therefore necessary in the early refeeding period
A Data on RFS incidence is lacking and the heterogeneity of diagnostic criteria and frequent electrolyte disorders in this population make its diagnosis complex In 2020 the American Society for Parenteral and Enteral Nutrition ASPEN developed consensus recommendations for identifying patients at risk and with refeeding syndrome These state that undernourished children are considered at risk of refeeding syndrome those who develop one significant electrolyte disorder decrease 10 in phosphorus potassium andor magnesium within the first five days of nutritional support combined with a significant increase in energy intake are considered to have refeeding syndrome
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None