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Abstract：
BACKGROUND: In the spring of 2017, the American Society for Parenteral and Enteral Nutrition (ASPEN) Parenteral Nutrition Safety Committee and the Clinical Practice Committee convened an interprofessional task force to develop consensus recommendations for identifying patients with or at risk for refeeding syndrome (RS) and for avoiding and managing the condition. This report provides narrative review and consensus recommendations in hospitalized adult and pediatric populations.
METHODS: Because of the variation in definitions and methods reported in the literature, a consensus process was developed. Subgroups of authors investigated specific issues through literature review. Summaries were presented to the entire group for discussion via email and teleconferences. Each section was then compiled into a master document, several revisions of which were reviewed by the committee.
UNASSIGNED: This group proposes a new clinical definition, and criteria for stratifying risk with treatment and screening strategies. The authors propose that RS diagnostic criteria be stratified as follows: a decrease in any 1, 2, or 3 of serum phosphorus, potassium, and/or magnesium levels by 10%-20% (mild), 20%-30% (moderate), or >30% and/or organ dysfunction resulting from a decrease in any of these and/or due to thiamin deficiency (severe), occurring within 5 days of reintroduction of calories.
CONCLUSIONS: These consensus recommendations are intended to provide guidance regarding recognizing risk and identifying, stratifying, avoiding and managing RS. This consensus definition is additionally intended to be used as a basis for further research into the incidence, consequences, pathophysiology, avoidance, and treatment of RS.
METHODS: Because of the variation in definitions and methods reported in the literature, a consensus process was developed. Subgroups of authors investigated specific issues through literature review. Summaries were presented to the entire group for discussion via email and teleconferences. Each section was then compiled into a master document, several revisions of which were reviewed by the committee.
UNASSIGNED: This group proposes a new clinical definition, and criteria for stratifying risk with treatment and screening strategies. The authors propose that RS diagnostic criteria be stratified as follows: a decrease in any 1, 2, or 3 of serum phosphorus, potassium, and/or magnesium levels by 10%-20% (mild), 20%-30% (moderate), or >30% and/or organ dysfunction resulting from a decrease in any of these and/or due to thiamin deficiency (severe), occurring within 5 days of reintroduction of calories.
CONCLUSIONS: These consensus recommendations are intended to provide guidance regarding recognizing risk and identifying, stratifying, avoiding and managing RS. This consensus definition is additionally intended to be used as a basis for further research into the incidence, consequences, pathophysiology, avoidance, and treatment of RS.
摘要：
背景：2017年春季，美国肠外和肠内营养学会（ASPEN）肠外营养安全委员会和临床实践委员会召集了一个跨专业工作组，以制定共识建议，以识别患有或有风险的患者重新喂养综合征（RS）并避免和管理病情。本报告提供了住院成人和儿科人群的叙述性回顾和共识建议。
方法：由于文献中报道的定义和方法的差异，形成了共识进程。作者亚组通过文献综述调查了具体问题。摘要通过电子邮件和电话会议提交给整个小组进行讨论。然后将每个部分汇编成一个主文档，委员会审查了其中的几项修订。
■这个小组提出了一个新的临床定义，以及通过治疗和筛查策略进行风险分层的标准。作者建议将RS诊断标准分层如下：血清磷的任何1、2或3减少，钾，和/或镁水平降低10%-20%(轻度)，20%-30%（中等），或>30％和/或器官功能障碍导致的任何这些和/或由于硫胺素缺乏（严重），在重新引入卡路里后的5天内发生。
结论：这些共识建议旨在提供有关识别风险和识别，分层，避免和管理RS。这一共识定义还旨在作为进一步研究发病率的基础。后果,病理生理学,回避,和RS的治疗。
方法：由于文献中报道的定义和方法的差异，形成了共识进程。作者亚组通过文献综述调查了具体问题。摘要通过电子邮件和电话会议提交给整个小组进行讨论。然后将每个部分汇编成一个主文档，委员会审查了其中的几项修订。
■这个小组提出了一个新的临床定义，以及通过治疗和筛查策略进行风险分层的标准。作者建议将RS诊断标准分层如下：血清磷的任何1、2或3减少，钾，和/或镁水平降低10%-20%(轻度)，20%-30%（中等），或>30％和/或器官功能障碍导致的任何这些和/或由于硫胺素缺乏（严重），在重新引入卡路里后的5天内发生。
结论：这些共识建议旨在提供有关识别风险和识别，分层，避免和管理RS。这一共识定义还旨在作为进一步研究发病率的基础。后果,病理生理学,回避,和RS的治疗。
