Prevalence and Outcomes of Refeeding Syndrome in Critically Ill Children: A Retrospective Study in a Tertiary Care Setting

OBJECTIVES: To determine the prevalence and outcome of refeeding syndrome in critically ill children admitted to the PICU. DESIGN: Retrospective cohort study. SETTING: Single PICU in a tertiary care university-affiliated hospital. PATIENTS: Children of age 1 month to 18 years hospitalized in the PICU between January 2018 and December 2022 were included in this study. INTERVENTION: None. MEASUREMENT AND MAIN RESULTS: We identified children with refeeding syndrome based on the 2020 guidelines established by the American Society for Parenteral and Enteral Nutrition. The outcomes measured included length of hospitalization, complications, and mortality rates. During the study period, a total of 404 children were admitted to the PICU, with 94 children (23.3%) classified as undernourished. Refeeding syndrome was diagnosed in 53 children (13.1%). Comorbidity with chronic neurologic conditions was prominently associated with greater adjusted odds of refeeding syndrome. An increase in BMI was associated with lower odds of developing refeeding syndrome. The median duration of hospital stay was significantly longer for children with refeeding syndrome compared with those without it. CONCLUSIONS: This study suggests that children at greater risk of developing refeeding syndrome were those with comorbid chronic neurologic conditions. Close monitoring of metabolic disturbances is crucial in the care of these patients.