Anaesthesia & ICU
Refeeding Syndrome
NICE CG32 — recognition of high-risk patients, slow reintroduction, monitor + replace electrolytes (P, K, Mg), thiamine.
Source: NICE CG32 (2006, updated 2017)
Step 1 of ~3
info
High-Risk Patients
NICE high-risk: 1 of (BMI <16, weight loss >15% in 3–6 months, little/no nutrition >10 days, low K/Mg/PO4 pre-feeding) OR 2 of (BMI <18.5, weight loss >10%, little/no intake >5 days, hx alcohol misuse / drugs incl. insulin / chemo / antacid / diuretics).
Settings: anorexia nervosa, alcohol use, cancer cachexia, post-bariatric, prolonged fasting (NBM in surgery).
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Thiamine (IV/IM — Pabrinex) · Vitamin B1 (Thiamine) — deficiency treatment / Wernicke's encephalopathy prevention
- Thiamine (Vitamin B1) · Vitamin B1 Supplement
- Palivizumab · RSV Prophylaxis — Monthly Monoclonal Antibody (High-Risk Infants)
- Hydroxocobalamin (High-Dose — Cyanide Antidote) · Cyanide Antidote (Vitamin B12 Precursor at High Dose)
- Calcium chloride · IV calcium salt (high elemental calcium)
- Aciclovir 800mg Tablets (Ramsay Hunt Syndrome / Herpes Zoster Oticus) · Antiviral — nucleoside analogue (herpes zoster treatment)
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Anaphylaxis Under Anaesthesia · AAGBI 2018; NAP6
- Malignant Hyperthermia · AAGBI 2011; MHAUS
- Local Anaesthetic Systemic Toxicity (LAST) · AAGBI 2010; ASRA 2017
- Spinal Anaesthesia Hypotension Management · AAGBI; ASA
- Postoperative Nausea & Vomiting · Society for Ambulatory Anesthesia 2020; AAGBI
Decision support only. Always apply local guidelines and clinical judgement.