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Refeeding Syndrome
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Jeong Wook Kim
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J Clin Nutr 2015;7(1):15-22. Published online April 30, 2015
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DOI: https://doi.org/10.15747/jcn.2015.7.1.15
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 Abstract
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Refeeding syndrome refers to a life-threatening shift of electrolytes and fluid with metabolic abnormalities in malnourished patients undergoing refeeding, whether orally, enterally, or parenterally. Clinical findings are fluid-balance abnormalities, abnormal glucose metabolism, hypophosphatemia, hypomagnesemia, hypokalemia and deficiencies of vitamin and trace element. Multiple organ systems including cardiac, respiratory, neurologic, renal, hematologic, and gastrointestinal can be affected. When recognized in a timely manner, these complications can be easily and successfully prevented and treated. Four factors appear fundamental: early identification of patients at risk, correction of abnormalities before refeeding, close monitoring during refeeding, and an appropriate feeding regimen. -
Citations
Citations to this article as recorded by  - Refeeding Syndrome after Gastrectomy in a Patient with Hypophosphatemia: A Case Report
Cheong Ah Oh
Annals of Clinical Nutrition and Metabolism.2022; 14(2): 88. CrossRef - Effects of Early Phosphorus Intake on Respiratory Distress in Extremely Low-Birth-Weight Infants
Hye Jung Bae, Hyung Woo Yoon, Moon Jin Kim, Ae Hee Jung, Sun Hoi Jung, Hyeon Joo Hahn, Yun Hee Jo, Yoon Sook Cho, Ee-Kyung Kim, Seung Han Shin, In Gyu Song, Seung Hyun Shin
Neonatal Medicine.2019; 26(3): 155. CrossRef
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A practical guide for enteral nutrition from the Korean Society for Parenteral and Enteral Nutrition: Part I. prescribing enteral nutrition orders
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Ye Rim Chang, Bo-Eun Kim, In Seok Lee, Yun Soo Cho, Sung-Sik Han, Eunjung Kim, Hyunjung Kim, Jae Hak Kim, Jeong Wook Kim, Sung Shin Kim, Eunhee Kong, Ja Kyung Min, Chi-Min Park, Jeongyun Park, Seungwan Ryu, Kyung Won Seo, Jung Mi Song, Minji Seok, Eunmi Sul, Jinhee Yoon, Jeong Meen Seo, for KSPEN Enteral Nutrition Committee
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Received March 4, 2025 Accepted March 28, 2025 Published online March 31, 2025
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DOI: https://doi.org/10.15747/ACNM.25.0002
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Abstract
ePub
- Purpose
This study aimed to develop a comprehensive practical guide for enteral nutrition (EN) designed to enhance patient safety and reduce complications in Korea. Under the leadership of the Korean Society for Parenteral and Enteral Nutrition (KSPEN), the initiative sought to standardize EN procedures, improve decision-making, and promote effective multidisciplinary communication.
Methods
The KSPEN EN committee identified key questions related to EN practices and organized them into seven sections such as prescribing, delivery route selection, formula preparation, administration, and quality management. Twenty-one experts, selected based on their expertise, conducted a thorough literature review to formulate evidence-based recommendations. Drafts underwent peer review both within and across disciplines, with final revisions completed by the KSPEN Guideline Committee. The guide, which will be published in three installments, addresses critical elements of EN therapy and safety protocols.
Results
The practical guide recommends that EN orders include detailed elements and advocates the use of electronic medical records for communication. Standardized prescription forms and supplementary safety measures are outlined. Review frequency is adjusted according to patient condition—daily for critically ill or unstable patients and as dictated by institutional protocols for stable patients. Evidence indicates that adherence to these protocols reduces mortality, complications, and prescription errors.
Conclusion
The KSPEN practical guide offers a robust framework for the safe delivery of EN tailored to Korea’s healthcare context. It emphasizes standardized protocols and interdisciplinary collaboration to improve nutritional outcomes, patient safety, and operational efficiency. Rigorous implementation and monitoring of adherence are critical for its success.
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