Refeeding Syndrome : Mnemonics

Risk factors

Mnemonic: ABCD

1. Alcohol abuse
2. BMI <18.5 kg/sq.meter
3. Chemotherapy
4. Drugs (insulin) and Diuretics

Pathophysiology

Mnemonic: PPM

Malnourished (depleted intracellular Phosphate, Potassium, Magnesium) → Refeeding → Increased glucose load → Insulin spikes → Drives PPM into cells → Hypophosphatemia (major abnormality), hypokalemia, hypomagnesemia

Prevention

If patient hasn’t not eaten for >5 days, aim to refeed at <50% energy and protein levels.

Monitor and aggresively supplement PPM.