The Effect of Enteral Nutrition on Refeeding Syndrome in Severely Malnourished Patients

Reintegrating nutrition back into individuals who are severely malnourished, especially those hospitalized for it, can be challenging and dangerous. Refeeding syndrome (RFS) can occur during these times. Scientific evidence indicates that a gradual refeeding using enteral nutrition support substantially reduces the risk for refeeding syndrome. The purpose of this systematic review was to determine if enteral nutrition was the best method of refeeding so that doctors and nurses can better help severely malnourished patients recover back to a substantial and nutritious diet. A PubMed and EBSCO search was performed using the terms “enteral nutrition and refeeding syndrome”. Studies were limited to those published within the past five years in English and working with hospitalized patients. Two studies showed no signs of RFS. Four of the studies showed signs of RFS based on abnormal electrolyte levels. These signs presented in patients that started the refeeding process with high caloric intakes. Patients either started with a very low BMI or showed weight loss during the study. Overall, for severely malnourished patients that have a hard time digesting food, enteral nutrition proved to be the safest method for incorporating nutrition back into one’s diet. Future research needs to be done with larger sample sizes and also with comparing other refeeding methods to the method of enteral nutrition.