Cuidados ao iniciar a terapia nutricional em pacientes com risco de síndrome de realimentação em unidade de terapia intensiva: revisão de literatura e um manual prático para profissionais de saúde

Abstract

Introduction: Refeeding syndrome (RS) is a serious and potentially fatal complication, characterized by metabolic disorders that occur when there is a reintroduction or increase in caloric supply after a period of fasting or inadequate food intake. Although it is commonly associated with parenteral feeding, RS can also affect patients fed enterally or orally. Regardless of the route of energy intake, it is essential to consider several factors when initiating and advancing caloric intake in patients at risk for RS. Objectives: to describe the refeeding syndrome, identify the risks associated with its occurrence in relation to the initiation of nutritional therapy in critically ill patients admitted to Intensive Care Units and develop a practical manual with the main information on the subject, to provide guidance to all healthcare professionals. Methodology: Literature review with a narrative approach, composed of relevant studies and knowledge that address the topic. This review aimed to bring together a volume of literature on the area in question in a summarized and synthesized form. Preparation of an illustrative and informative practical manual. Final Considerations: The occurrence of refeeding syndrome in patients admitted to intensive care units is not a rare event. Although the pathophysiology of this syndrome in patients undergoing nutritional support is not yet completely elucidated, there is consensus that it can significantly impact the prognosis, especially in malnourished patients. In this context, it is crucial to identify the risk factors associated with the initiation of nutritional therapy and the development of RS.