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Refeeding-Syndrom bei geriatrischen Patienten

Eine oft übersehene Komplikation

Refeeding syndrome in geriatric patients

A frequently overlooked complication

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Zusammenfassung

Das Refeeding-Syndrom ist eine lebensbedrohliche Komplikation, die bei Beginn einer Ernährungstherapie bei mangelernährten Patienten entstehen kann. Bei Kenntnis der Risikofaktoren und der Pathophysiologie kann ihrer Entwicklung wirksam vorgebeugt werden bzw. bei frühzeitiger Erkennung eine wirksame Behandlung erfolgen. Ein langsamer Kostaufbau und die engmaschige Überwachung der Serum-Elektrolyt-Spiegel spielen eine zentrale Rolle. Da das Refeeding-Syndrom wenig bekannt ist und die Symptomatik sehr vielgestaltig sein kann, wird diese Komplikation, insbesondere vor dem Hintergrund der geriatrischen Multimorbidität, sehr häufig nicht erkannt. Die vorliegende Übersicht möchte für die Bedeutung des Refeeding-Syndroms bei der besonderen Risikogruppe der geriatrischen Patienten sensibilisieren.

Abstract

The refeeding syndrome is a life-threatening complication that can occur after initiation of a nutrition therapy in malnourished patients. If the risk factors and pathophysiology are known, the refeeding syndrome can effectively be prevented and treated, if recognized early. A slow increase of food intake and the close monitoring of serum electrolyte levels play an important role. Because the refeeding syndrome is not well known and the symptoms may vary extremely, this complication is poorly recognized, especially against the background of geriatric multimorbidity. This overview is intended to increase the awareness of the refeeding syndrome in the risk group of geriatric patients.

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Author information

Authors and Affiliations

  1. Klinik für Altersmedizin und Frührehabilitation, Marien Hospital Herne, Universitätsklinikum der Ruhr-Universität Bochum, Herne, Deutschland

    Rainer Wirth

  2. Lehrstuhl für Geriatrie, Ruhr-Universität Bochum, Bochum, Deutschland

    Rainer Wirth & Annika Kreilkamp

  3. Universitätsklinik für Geriatrie, Klinikum Oldenburg, Oldenburg, Deutschland

    Rebecca Diekmann

  4. Klinik für Innere Medizin, Franziskus Hospital Bielefeld, Bielefeld, Deutschland

    Olga Fleiter

  5. Klinik für Geriatrie, St. Katharinen-Krankenhaus, Frankfurt, Deutschland

    Leonhardt Fricke

  6. Klinik für Geriatrie, Sana Hanse-Klinikum Wismar, Wismar, Deutschland

    Mirja Katrin Modreker

  7. Klinik für Geriatrische Rehabilitation, Klinikum Christophsbad, Göppingen, Deutschland

    Christian Marburger

  8. Klinik für Geriatrie, Hochtaunus Kliniken, Bad Homburg, Deutschland

    Stefan Nels

  9. Klinik für Geriatrie, Marien-Krankenhaus Bergisch-Gladbach, Bergisch-Gladbach, Deutschland

    Rolf Schaefer

  10. Klinik für Innere Medizin/Geriatrie, Malteser Krankenhaus St. Josefshospital, Krefeld, Deutschland

    Heinz-Peter Willschrei

  11. Institut für Biomedizin des Alterns, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Deutschland

    Dorothee Volkert

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Arbeitsgruppe Ernährung und Stoffwechsel der Deutschen Gesellschaft für Geriatrie (DGG)

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Correspondence to Rainer Wirth.

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Interessenkonflikt

R. Wirth, R. Diekmann, O. Fleiter, L. Fricke, A. Kreilkamp, M.K. Modreker, C. Marburger, S. Nels, R. Schaefer, H.-P. Willschrei und D. Volkert geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Wirth, R., Diekmann, R., Fleiter, O. et al. Refeeding-Syndrom bei geriatrischen Patienten. Z Gerontol Geriat 51, 34–40 (2018). https://doi.org/10.1007/s00391-016-1160-8

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  • DOI: https://doi.org/10.1007/s00391-016-1160-8

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