Prevalence, risk factors, and outcomes of refeeding-like syndrome in very low birth weight infants: A descriptive study.
Reinforcessuggested applicable standard· ESPEN (European Society for Clinical Nutrition and Metabolism), "ESPEN guideline on chronic intestinal failure in adults, Update 2023," Clinical Nutrition, 2023
Decision at stakemonitor for refeeding syndrome in patients receiving parenteral nutrition
Manage short bowel syndrome / intestinal failure with a multidisciplinary IF team using a three-phase nutrition strategy: initiate TPN with IV hydration and electrolyte replacement in the acute hypersecretory phase, progressively advance enteral feeds and wean PN during the 1-2 year adaptation phase, then maintain an oral diet with selective PN as needed. …
From our summary of this standard, unedited — the part the paper bears on. … marks omitted text. Our wording, not the guideline's; read the source for its own text.
Our full summary of this standard
Manage short bowel syndrome / intestinal failure with a multidisciplinary IF team using a three-phase nutrition strategy: initiate TPN with IV hydration and electrolyte replacement in the acute hypersecretory phase, progressively advance enteral feeds and wean PN during the 1-2 year adaptation phase, then maintain an oral diet with selective PN as needed. In carefully selected PN-dependent patients, and only when prescribed by clinicians experienced in SBS/IF management (generally once the adaptation phase is complete), consider the GLP-2 analog teduglutide (0.05 mg/kg/day subcutaneously) to promote intestinal adaptation and reduce PN volume, but only after baseline screening to exclude neoplasia and contraindications (colonoscopy with removal of any polyps when colon and/or rectum is present, and assessment for active or recent [within 5 years] gastrointestinal, hepatobiliary, or pancreatic malignancy, which contraindicate its use) and with mandatory ongoing safety monitoring (surveillance colonoscopy after 1-2 years then every 5 years, plus vigilance for colorectal/GI polyps and neoplasia, intestinal obstruction, biliary/gallbladder and pancreatic disease, and fluid overload); add antimotility agents (loperamide, then codeine/opium tincture) for high-output stoma, and provide lifelong nutrient surveillance/supplementation (notably B12) plus monitoring for CRBSI, IFALD, oxalate stones, and refeeding syndrome.