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refeeding syndrome in Southeastern Taiwan:Our experience with 11 cases

World Journal of Gastroenterology 2014年第30期20卷 10525-10530页

作者： Li-Ju Chen Huan-Lin Chen Ming-Jong Bair Chia-Hsien Wu I-Tsung Lin Yuan-Kai Lee Cheng-Hsin Chu Department of Nutrition Mackay Memorial Hospital Division of Gastroenterology Department of Internal MedicineMackay Memorial Hospital Department of Nursing Meiho University Department of Pharmacy and Graduate Institute of Pharmaceutical Technology Tajen University Department of Nutrition and Gastroenterology Mackay Memorial Hospital Mackay Junior College of Medicine Nursingand Management College

AIM: To present our experience with refeeding syndrome in southeastern Taiwan.

关键词： refeeding syndrome Nutrition status Cachexia Hypophosphatemia Risk assessment

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Enteral refeeding syndrome after long-term total parenteral nutrition

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Chinese Medical Journal 2006年第22期119卷 1856-1860页

作者： REN Jian-an MAO Yao WANG Ge-fei WANG Xing-bo FAN Chao-gang WANG Zhi-ming LI Jie-shou Department of Surgery Jinling Hospital Medical School of Nanjing University Nanjing 210002 China

Background Early enteral feeding （EF） may result in fever, elevated white blood cell count, increased serum levels of liver enzymes, and diarrhea. We name the complications ＂enteral refeeding syndrome＂, as a subtype of refeeding syndrome, because they are likely to result from long-term lack of lumen nutrition. The aim of this study was to investigate the characteristics of enteral refeeding syndrome after long-term total parenteral nutrition （TPN）, and the solution for the disease. Methods We collected the clinical data of 100 patients with gastrointestinal fistula, who were cured from Apirl 2001 to July 2002. Their fasting time, daily stool frequency, body temperature, heart rate, respiratory rate, levels of transaminases, alkaline phosphatase （AKP）, and γ-glutamylcyclotransferase （γ-GT）, white blood cell count, and systemic inflammatory reaction syndrome （SIRS） score were recorded before and 1, 3, 5, 10, and 15 days after EF. Student＇s t test and analysis of variance were used to analyze the data. Results Of the 100 patients, 56 were cured after selective resection of intestinal fistula, 15 were cured by emergency operation, and 29 recovered spontaneously. The levels of AKP and y-GT increased significantly on the 3rd day after EF [On the 3rd day after EF, （243.0±121.6） U/L and （177.2±109.9） U/L vs. before EF （181.5±127.5） U/L and （118.4±94.2） U/L, P〈0.05], and decreased gradually afterwards. The SIRS scores on the 1st day （1.05±1.08） and 3rd day （0.96±1.11） after EF were significantly higher than that before EF （0.72＋0.84）, then decreased to 0.83±0.91, 0.49±0.73 and 0.32±0.60 on the 5th, 10th and 15th days after EE The number of patients with diarrhea at 1, 3, 5, 10 and 15 days post-EF were 31, 26, 12, 13, and 7, respectively. Conclusions The longer the TPN lasts, the more severe the enteral refeeding syndrome becomes. Continuous EF is effective for the syndrome. Early enteral nutrition is useful in preventing it.

关键词： enteral nutrition refeeding syndrome gastrointestinal fistula diarrhea cholestasis

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Gastroenteric tube feeding: Techniques, problems and solutions

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World Journal of Gastroenterology 2014年第26期20卷 8505-8524页

作者： Irina Blumenstein Yogesh M Shastri Jürgen Stein Department of Gastroenterology and Clinical Nutrition Johann Wolfgang Goethe University Clinic Gastroenterology and Clinical Nutrition Hospital Sachsenhausen Crohn Colitis Clinical Research Center RheinMain

Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake,chronic neurological or mechanical dysphagia or gut dysfunction,and patients who are critically ***,despite the benefits and widespread use of enteral tube feeding,some patients experience *** review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding,together with associated complications and special *** conducted an extensive literature search on PubMed,Embase and Medline using index terms relating to enteral access,enteral feeding/nutrition,tube feeding,percutaneous endoscopic gastrostomy/jejunostomy,endoscopic nasoenteric tube,nasogastric tube,and refeeding *** literature showed common routes of enteral access to include nasoenteral tube,gastrostomy and jejunostomy,while complications fall into four major categories:mechanical,e.g.,tube blockage or removal;gastrointestinal,e.g.,diarrhea;infectious e.g.,aspiration pneumonia,tube site infection;and metabolic,e.g.,refeeding syndrome,*** the type and frequency of complications arising from tube feeding vary considerably according to the chosen access route,gastrointestinal complications are without doubt the most *** associated with enteral tube feeding can be reduced by careful observance of guidelines,including those related to food composition,administration rate,portion size,food temperature and patient supervision.

关键词： Enteral tube feeding Percutaneous endoscopic gastrostomy refeeding syndrome Enteral nutrition Buried bumper syndrome Nasoenteral tubes Colocutaneous fistulae

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