The role of nurses in the prevention and management of refeeding syndrome in critically Ill patients

Abstract

Refeeding Syndrome (RFS) is a severe and potentially life-threatening metabolic condition that may occur when nutritional support is rapidly reintroduced in patients with prolonged severe malnutrition. This condition results in abrupt metabolic changes, fluid imbalance and electrolyte disturbances, particularly hypophosphatemia, hypokalemia and hypomagnesemia, which may lead to serious complications involving the cardiovascular, respiratory and neurological systems. RFS is especially prevalent and severe in critically ill patients, who often have pre-existing malnutrition and unstable metabolic and organ function. Consequently, prevention and appropriate nutritional management remain a major challenge for the healthcare team.

Nurses, as primary caregivers in the intensive care unit, play a crucial role in identifying high-risk patients, preventing complications and ensuring early detection and timely management of RFS. Nurses should possess comprehensive knowledge of the pathophysiology of RFS and demonstrate competency in implementing standardized care practices. These include nutritional risk screening, assessment of nutritional status, appropriate administration of nutritional support and close monitoring for clinical signs and symptoms of RFS before, during and after the initiation of nutrition therapy. Systematic documentation and effective communication with the multidisciplinary team are essential to ensure continuity of care and patient safety. Strengthening nursing competencies in nutritional assessment, monitoring and interdisciplinary communication can significantly reduce the incidence and severity of RFS in critically ill patients and contribute to improved quality of nutritional care in the intensive care unit.