Psychiatria pre prax 4/2002

The Risk of the Refeeding Syndrome in Mental Anorexia

This article deals with the risk of th so-called, refeeding syndrome, in patients with the serious form of mental anorexia. The author describes the patient’s state, where a serious hypophosphoraemia stands in connection with enteral nutrition intake and the adverse effects due to artificial ventilation. By biochemical analysis it was found that hypophosphoraemia is connected with continous nutritional support. The second part presents a study where the electrolyte levels and their decrease in patients with mental anorexia and at the same time in a control group was followed. Upon the conclusion of the named study the patients suffering from the serious form of mental anorexia, where nutritional support was undertaken, had a low loss of chloride, sodium and phosphate and a low serum level of phosphate, magnesium and calcium. From these results can be predicted a risk of the refeeding syndrome occurring and the possibility of complications (paraesthesia, muscle paralysis, malignant arrythmia, breathing disorders) after nutritional support proceeds. The last part of the article presents a method for electrolyte substitution in patients suffering from the serious form of mental anorexia and with the signs of severe deficiency.

Keywords: refeeding syndrome, hypophosphoraemia, glycide energy, mineral dysbalance, intracelular cations, severe malnutrition, nutrition support.