Nutrition & Metabolism
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Pathophysiology of Refeeding Syndrome:
In poorly nourished patients, intracellular phosphate becomes depleted and insulin secretion decreases. Providing carbohydrates increases insulin secretion which stimulates cells to take up phosphate causing severe hypophosphatemia and preventing cells from producing enough 2,3-diphosphoglycerate and ATP to meet metabolic demands.
Symptoms occur by the 2nd or 3rd day of improved nutrition and include weakness, confusion, dysrhythmias, respiratory failure, CHF, hypotension, ileus, metabolic acidosis, seizures, coma, and sudden death.
Recommended oral calcium intake:
- 1000mg/day - men & premenopausal women
- 1500mg/day - postmenopausal women & pts with osteoporosis (+ 400-800IU vit D)
Recommended Vitamin D intake:
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