Le syndrome de renutrition inappropriée : la clé du traitement est la prévention | Refeeding syndrome: Prevention is the key to the treatment
2011
Barras-Moret, Anne-Catherine | Guex, Esther | Coti Bertrand, Pauline
In a context where particular awareness of doctors and nurses to undernutrition leads to more and more systematic nutritional care, inappropriate renutrition syndrome (IRS) is often underdiagnosed. However IRS has been described as a potentially lethal condition for almost a century. IRS is defined as all biological and clinical adverse reactions that occur during renutrition of undernourished or long fasting patients. If renutrition is too rapid, it leads to an abrupt decrease in plasma levels of phosphate, magnesium, potassium and thiamine, and to several organ failures including cardiac, neurological, respiratory, renal, hepatic, muscular and haematological. Today, prevention of IRS is well codified and should allow reducing its morbidity and mortality. For this purpose, it is of prime importance to identify patients at high risk of IRS to allow for a biological and clinical monitoring adapted to this risk's severity. The objectives of IRS care are to achieve first hydro-electrolytic and vitamin balance. Then, and only after all nutritional deficiencies are corrected, they aim towards cautious and gradual energy restoration.
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