The following is a summary of “Refeeding Syndrome in Pediatric Age, An Unknown Disease: A Narrative Review,” published in the December 2023 issue of Pediatrics by Corsello, et al.

Refeeding Syndrome (RS), characterized by electrolyte imbalances, poses a potential threat in adults and children, albeit with limited evidence in pediatrics. For a study, researchers sought to comprehensively explore RS in pediatric clinical settings and propose an effective management algorithm.

Incidence of up to 7.4% in pediatric intensive care units highlighted the significance of understanding RS. Triggered by abrupt nutritional resumption, RS is particularly prevalent in severely malnourished individuals. Clinical manifestations include weakness, seizures, and heart failure, emphasizing the critical need for monitoring electrolyte levels. The study underscored risk factors such as severe malnutrition, chronic malabsorption, and prolonged fasting.

Initiating refeeding cautiously with small amounts of low-calorie fluids, followed by a gradual increase in caloric intake over several days, emerges as a preventive strategy. Prophylactic use of dietary supplements, especially thiamine, proved essential to counteract potential imbalances. The study stressed the importance of close monitoring and individualized adjustments based on electrolyte assessments.

In pediatric clinical practice, a stepwise refeeding approach, meticulous electrolyte monitoring, and proactive supplement administration are pivotal to preventing and managing RS. This strategy, guided by a thorough understanding of risk factors and early symptoms, ensured optimal outcomes for pediatric patients undergoing nutritional support.

Source: journals.lww.com/jpgn/fulltext/2023/12000/refeeding_syndrome_in_pediatric_age,_an_unknown.5.aspx