NST에 의뢰된 저체중 환자군에서 입원초기 영양투여에 따른 영양재개증후군의 발생 위험 평가
Assessment of Risk of Refeeding Syndrome Caused by Early Nutrition in Low Body Weight Patients Referred to NST
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background : Refeeding syndrome (RS) can result from after nutrition is provided to patients with a low nutritional status. RS is generally caused by electrolyte imbalances, such as hypokalemia, hypomagnesemia, and hypophosphatemia. RS can cause cardiovascular and nervous system side effects, leading to death of the patient. Methods : In this study, 27 patients who were referred to our nutritional support team (NST) during the 6-month study period were divided into a low weight group with BMIs less than 16 kg/m2 and a normal weight group (100 to 105% of standard weights). We evaluated the nutritional doses given to the two groups at the time of initiation of parenteral or enteral nutrition and after three days, and compared the degree of RS expression based on hematologic clinical results. Results : Blood tests for phosphorus were significantly decreased in the low weight group compared to the normal weight group (p=0.028). The caloric dose on the first day of the low weight group was statistically higher than the normal weight group (p=0.005). Conclusions : The risk of RS was higher in patients with BMIs less than 16 kg/m2 who initially received high-calorie nutritional doses of 80% or more of the required dose, than in patients with normal body weights and calorie content below 50% of the required dose.
Abstract
Background : Refeeding syndrome (RS) can result from after nutrition is provided to patients with a low nutritional status. RS is generally caused by electrolyte imbalances, such as hypokalemia, hypomagnesemia, and hypophosphatemia. RS can cause cardiovascular and nervous system side effects, leading to death of the patient. Methods : In this study, 27 patients who were referred to our nutritional support team (NST) during the 6-month study period were divided into a low weight group with BMIs less than 16 kg/m2 and a normal weight group (100 to 105% of standard weights). We evaluated the nutritional doses given to the two groups at the time of initiation of parenteral or enteral nutrition and after three days, and compared the degree of RS expression based on hematologic clinical results. Results : Blood tests for phosphorus were significantly decreased in the low weight group compared to the normal weight group (p=0.028). The caloric dose on the first day of the low weight group was statistically higher than the normal weight group (p=0.005). Conclusions : The risk of RS was higher in patients with BMIs less than 16 kg/m2 who initially received high-calorie nutritional doses of 80% or more of the required dose, than in patients with normal body weights and calorie content below 50% of the required dose.
참고문헌 (10)
- 김정욱, "영양재개증후군", 한국정맥경장영양학회지, 7(1), pp.15~22 (2015)
- Schnitker MA, "A clinical study of malnutrition in Japanese prisoners of war", Ann Intern Med, 35(1), pp.69~96 (1951)
- Crook MA, "The importance of the refeeding syndrome", Nutrition, 17(7), pp.632~637 (2001)
- Walmsley RS, "Refeeding syndrome : Screening, incidence, and treatment during parenteral nutrition", J Gastroenterol Hepatol, 28, pp.113~117 (2013)
- 윤정이, "자유연제: 심한 영양결핍증 환자에서 정맥영양제 투여 계획에 따른Refeeding syndrome의 발현 정도", 한국정맥경장영양학회 학술발표논문집, pp.109~110 (2001)
- Nutrition support for adults. Clinical Guideline No. 32, "National Institute for Clinical Excellence", National Collaborating Centre for Acute Care (UK), 1~176 (2006)
- Friedly N, "Revisiting the refeeding syndrome : Results of a systematic review", Nutrition, 35, pp.151~160 (2017)
- Khan LU, "Refeeding syndrome: A literature review", Gastroenterol Res Pract (2011)[DOI]
- Muller C, "The A.S.P.E.N adult nutrition support core curriculum", pp.102~114 (2012), Silver Spring
- 고진영, "중환자 약물 처방 이해", pp.249~250 (2017), 우리의학서적
