Síndrome de Realimentación
[Refeeding Síndrome]Laura Fernandez Castañeda1, Edwin Araúz2, Abdullah Salehji3
1. Servicio de Medicina Interna, Complejo Hospitalario Dr Arnulfo Arias Madrid, Panamá, Rep de Panamá; 2. Complejo Hospitalario Dr Arnulfo Arias Madrid, Panamá, República de Panamá; 3. Complejo Hospitalario Dr Arnulfo Arias Madrid, Panamá, República de Panamá ;
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Resumen
El Síndrome de Realimentación (SR) ocurre posterior a la reintroducción de dieta enteral, parenteral u oral en pacientes con malnutrición; caracterizándose por alteraciones metabólicas y electrolíticas que aparecen cinco días después de la introducción del aporte calórico. Su incidencia y mortalidad es variable debido a la baja sospecha diagnóstica y desconocimiento del tema. La aparición de las manifestaciones clínicas depende de la alteración electrolítica; por lo general afectando múltiples sistemas. La prevención se basa en la identificación de individuos con factores de riesgo, instaurar un régimen nutricional adecuado y constante monitorización durante la realimentación. El manejo multidisciplinario es dirigido a la corrección de los trastornos hidroelectrolíticos y correcto inicio y optimización de la nutrición. Representa una entidad subdiagnosticada ya que no existen criterios universalmente establecidos. A pesar de que hoy en día, existe mayor conocimiento sobre la fisiología y fisiopatología de la enfermedad, la presentación inespecífica de los síntomas requiere un alto grado de sospecha para el diagnóstico. Por esta razón, la importancia de esta revisión.
Abstract
Refeeding Syndrome (RS) occurs after the reintroduction of enteral, parenteral or oral diet in patients with malnutrition; it is characterized by metabolic and electrolyte alterations that appear five days after the introduction of caloric intake. Its incidence and mortality is variable due to the low diagnostic suspicion and lack of knowledge on the subject. The appearance of clinical manifestations depends on the electrolyte alteration, usually affecting multiple systems. Prevention is based on the identification of individuals with risk factors, establishing an adequate nutritional regimen and constant monitoring during refeeding. Multidisciplinary management is directed to the correction of water and electrolyte disorders and correct initiation and optimization of nutrition. It represents an underdiagnosed entity since there are no universally established criteria. Although nowadays, there is greater knowledge about the physiology and pathophysiology of the disease, the non-specific presentation of symptoms requires a high degree of suspicion for diagnosis. For this reason, the importance of this review.
Citas
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