Document Detail

Refeeding hypophosphataemia is more common in enteral than parenteral feeding in adult in patients.
MedLine Citation:
PMID:  21256638     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: Refeeding hypophosphataemia (RH) can result in sudden death. This study aimed to compare the incidence of RH between patients fed enterally and those fed parenterally.
METHODS: The risk of RH in adult patients fed parenterally (PN) or nasogastrically (NG) was assessed by comparison of patient records with the UK NICE guidelines for refeeding syndrome, between December 2007 and December 2008. A fall in serum phosphate to less than 0.6 mmol/L was indicative of RH.
RESULTS: Of 321 patients,92 were at risk of RH. Of these, 23 (25%) patients developed RH (p = 0.003). 18 (33%) of NG fed, 'at-risk' patients developed RH vs 5 (13%) fed parenterally (p = 0.03). Death within 7 days and RH were not associated. The sensitivity and specificity of the NICE criteria for defining patient's risk of RH was calculated: 0.76 and 0.50 respectively for NG feeding; 0.73 and 0.38 respectively for parenteral feeding.
CONCLUSION: Patients fed by NG tube and deemed at risk of RH are more likely to develop RH than patients fed by PN. The higher risk with NG feeding may be due to the incretin effect from absorption of glucose. The UK guidelines lack specificity.
Sebastian Zeki; Alison Culkin; Simon M Gabe; Jeremy M Nightingale
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2011-01-21
Journal Detail:
Title:  Clinical nutrition (Edinburgh, Scotland)     Volume:  30     ISSN:  1532-1983     ISO Abbreviation:  Clin Nutr     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-30     Completed Date:  2011-10-03     Revised Date:  2012-07-13    
Medline Journal Info:
Nlm Unique ID:  8309603     Medline TA:  Clin Nutr     Country:  England    
Other Details:
Languages:  eng     Pagination:  365-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Lennard-Jones Intestinal Failure Unit, St. Mark's hospital, Harrow, Middlesex, UK.
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MeSH Terms
Aged, 80 and over
Enteral Nutrition* / adverse effects
Great Britain / epidemiology
Hypophosphatemia / epidemiology*,  etiology
Intubation, Gastrointestinal
Medical Records
Middle Aged
National Health Programs
Parenteral Nutrition* / adverse effects
Phosphates / blood
Practice Guidelines as Topic
Refeeding Syndrome / blood*,  epidemiology*,  mortality,  physiopathology
Retrospective Studies
Risk Factors
Sensitivity and Specificity
Water-Electrolyte Imbalance / etiology
Young Adult
Reg. No./Substance:
Comment In:
Clin Nutr. 2012 Jun;31(3):429; author reply 430   [PMID:  22154934 ]

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