Identification and prevention of refeeding syndrome in pediatric intensive care

“Refeeding syndrome” is described in the literature as a range of metabolic and electrolyte disorders that result from starting nutritional rehabilitation in malnourished patients. Without a universally accepted definition, data on “refeeding syndrome” incidence are heterogeneous. In most cases, a clinician will subjectively identify “refeeding syndrome,” many authors have developed their purposes and criteria for it in their studies. Using the PubMed database and the appropriate filters (“refeeding syndrome”-related terms: refeeding syndrome, pediatrics, child, nutrition support, nutrition assessment, malnutrition), a search of the published literature was conducted. The American Society for Parenteral and Enteral Nutrition’s 2020 recommendations are the only guidelines for identifying children with or at risk for “refeeding syndrome”. High-quality scientific evidence regarding the clinical syndrome is absent, so we need further research in all “refeeding syndrome”-related areas, from validation to better identification of risk factors, definitions of “refeeding syndrome,” and standardization of treatment protocols. For now, clinicians must remain vigilant to protect patients from the potentially devastating consequences of the “refeeding syndrome.”