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Re-feeding Risk (Who's at risk? (Chronic GI symptoms, Post GI surgery,…
Re-feeding Risk
Starvation Syndrome
Semi starvation (loss of 25% body wt) produced profound changes to:
Behaviour
Mood
Thinking
they became:
ritualised eating
rigid obsessive thinking
preoccupied w food
depressed mood
social withdrawl
These changes reversed w return of proper oral intake
High risk of developing re-feeding probs if:
One or more of the following:
Unintentional wt loss >15% in last 3-6 mths
Little or no nut intake in last 10 days
BMI less than 16kg/m
Low levels of K, PO4 or Mg prior to feeding
Two or more of the following:
Unintentional wt loss >10% in last 3-6 mths
Little or no nut intake in more than 5 days
BMI less than 18.5kg/m
A hx of EtOH abuse or drugs inc insulin, chemotherapy, antacids or diuretics
Who's at risk?
Chronic GI symptoms
Post GI surgery
Chronic debilitating disease
Post head and neck surgery
Current or recent hx of cancer
Elderly pts iving alone
Chronic dieting
ED's
Alcohol dependance syndrome
Supplementation
Thiamine 300mg IV/IM for 1st 3 days - orally thereafter
Daily MVI w trace elements
Thiamine
Co-factor in CHO metabolism
Important for heart and brain
Symptoms of deficiency
Muscle wasting
Cardiomegaly
Muscle weakness
Oedema
Tachycarida
Wernicke's encephalopathy