Symptoms and General Pathology

All Conditions

Nutritional and Metabolic Diseases

Critical Illness

Syndrome

Refeeding Syndrome

Disease Attributes

Malnutrition

Nutrition Disorders

Micronutrients

All Drugs and Chemicals

Vitamins

Thiamine

Thiamin

Vitamin B1

Patients will undergo a caloric management protocol:

Days 1 and 2:

1. Reduction of caloric intake to 5kcal/kg/day;
2. Replacement of serum phosforus, potassium and magnesium;
3. Administration of 100mg intravenous thiamine, vitamins and microelements.

From day 3:

1. If serum phosphorus \< 2.5mg/dL, protocol will be followed according to day 2;
2. If serum phosphorus \> 2.5mg/dL, a gradual increase to target caloric intake will ensue.

1. Nutritional management will be followed according to institutional protocol.
2. Electrolyte replacement will be provided at the clinician's discretion.

Strategy based on reduction of nutritional intake and electrolyte replacement.

Caloric Management Protocol

Ludhmila A Hajjar, MD, PhD

Eduardo A Osawa, MD, PhD

Ilana Roitman

Clarice H Park, MD, PhD

Gisele Queiroz, MD

The purpose of this study is to evaluate whether a nutritional strategy is effective in critically ill patients with cancer diagnosed with refeeding syndrome.

Refeeding syndrome is a clinical entity triggered by the introduction of calories in chronically undernourished patients. A number of organs may be affected due to imbalance of fluids and electrolytes. In the intensive care setting, there are no formal guidelines to recommend the appropriate treatment of this condition. The aim of this study is to evaluate the implementation of a nutritional protocol to address cancer patients admitted to the ICU with refeeding syndrome.

Refeeding Syndrome in Cancer Patients

Refeeding Syndrome in Cancer Patients Admitted to Adult Intensive Care Unit

Score of the number and severity of organ failures during ICU stay

Incidence of acute ischemic event or acute heart failure

Incidence of delirium according to CAM-ICU

Incidence of acute kidney injury according to KDIGO

Number of days in renal replacement therapy

Number of episodes of the following events: hypoglycemia, diarrhea, ileous, nausea and vomiting.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Refeeding Syndrome in Cancer Patients	NCT02534181	Refeeding Syndr... Cancer Critical Illnes...	Caloric Managem...	18 Years -	University of Sao Paulo
Refeeding Syndrome in Cancer Patients	NCT02534181	Refeeding Syndr... Cancer Critical Illnes...	Caloric Managem...	18 Years -	University of Sao Paulo
Refeeding Syndrome in Cancer Patients	NCT02534181	Refeeding Syndr... Cancer Critical Illnes...	Caloric Managem...	18 Years -	University of Sao Paulo

Spots Global Cancer Trial Database for caloric management protocol