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CASE REPORT  NON-COVID-19 SECTION Open accessopen access

Italian Journal of Emergency Medicine 2021 August;10(2):91-4

DOI: 10.23736/S2532-1285.21.00080-X

Copyright © 2021 THE AUTHORS

This is an open access article under the CC BY-NC-ND license

lingua: Inglese

Refeeding syndrome in the Emergency Medicine Department: management, prevention and challenges of a nutritional emergency

Paolo CANEPA 1 , Matteo CAITI 2, Paolo MOSCATELLI 2

1 Postgraduate School of Emergency Medicine, San Martino Hospital, Genoa, Italy; 2 Unit of Emergency Medicine 2, San Martino Hospital, Genoa, Italy



Refeeding syndrome (RS) is a common cause of metabolic dysfunction caused by malnutrition. After re-starting feeding there is a start of insulin release (response to glycemic levels), glycogen, lipids and proteins and development of dysionias if not treated. We presented the case of a cachetic 84-year-old woman with a nervous anorexia presenting in Emergency Department (ED) reporting confusion and asthenia associated to nor nutrition nor hydration for days. Blood chemistry tests were performed showing severe hypoglycemia, hypoalbuminemia with liver involvement. During hospitalization was started a total parenteral nutrition with later worsening of consciousness, severe hypophosphatemia, hyperlacticaemia, hypomagnesemia and worsening on hypoalbuminemia. A nutritional assessment, suspecting a refeeding syndrome, was performed with a controlled enteral nutrition followed by normalization of dysionias and clinical improvement.


KEY WORDS: Refeeding syndrome; Malnutrition; Metabolic diseases

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