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Curr Opin Clin Nutr Metab Care · Mar 2021
ReviewElectrolyte disorders during the initiation of nutrition therapy in the ICU.
- Reintam BlaserAnnikaADepartment of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia.Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Luzern, Switzerland. and van ZantenArthur Raymond HubertARHDepartment of Intensive Care Medicine, Gelderse Vallei Hospital, Ede, The Netherlands.Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands..
- Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia.
- Curr Opin Clin Nutr Metab Care. 2021 Mar 1; 24 (2): 151-158.
Purpose Of ReviewTo summarize recent evidence on prevalence, risk factors, significance, treatment, and prevention of electrolyte disorders in critically ill with a specific focus on disorders during the initiation of nutrition.Recent FindingsElectrolyte disturbances appear to occur often during critical illness, and most of them seem to be associated with impaired outcome. However, a recent systematic review indicated insufficient evidence to answer clinically relevant questions regarding hypophosphatemia. Similar questions (which thresholds of serum levels are clinically relevant; how serum levels should be corrected and how do different correction regimens/approaches influence outcome) are not clearly answered also for other electrolytes. The most crucial feature of electrolyte disturbances related to feeding is refeeding syndrome. Recent evidence supports that additionally to the correction of electrolyte levels, a temporary restriction of calories (reducing the magnitude of this metabolic feature, including electrolyte shifts) may help to improve outcome.SummaryDiverse electrolyte disorders often occur in critically ill patients. Hypophosphatemia, hypokalemia, and hypomagnesemia that are encountered after initiation of feeding identify refeeding syndrome. Along with correction of electrolytes, reduction of caloric intake may improve the outcome of the refeeding syndrome.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
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