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Evidence supporting the safety of rapid refeeding protocols, using a food based approach, in a paediatric inpatient eating disorder program
Journal of Eating Disorders volume 1, Article number: O17 (2013)
Historically, a cautious approach to refeeding has been taken due to lack of evidence about refeeding syndrome. The aim of this study was to evaluate outcomes following the introduction of a more aggressive feeding protocol in a paediatric eating disorder program. This included commencing at a higher energy intake, more rapid energy increases and macronutrient manipulation of meal plans while maintaining a food based approach.
A restrospective audit of 38 Austin Hospital patients admitted for medical stabilisation of their eating disorder, using rapid refeeding protocols, were compared to previous refeeeding protocols. Thirty-seven patients (97%) were commenced on 8.2 megajoules (MJ) or more and increased to 11 MJ within one week. Previously, 23 patients (60%) had commenced on 6.8 MJ or less. With more intensive feeding 30 patients (79%) gained more than the target of 1 to 1.5 kilograms per week (compared to 35% previously). Evidence of refeeding syndrome was identified and treated in only two patients (5%). Only one patient required a lower energy intake (6.5MJ) with reduced contribution to energy from carbohydrates (40%) due to high risk of refeeding syndrome.
These findings suggest more rapid refeeding can be achieved safely with a food based approach in this patient group.
This abstract was presented in the Care in Inpatient and Community Settings stream of the 2013 ANZAED Conference.
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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( https://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.
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Edsall, S., Bruere, T., Draffin, K. et al. Evidence supporting the safety of rapid refeeding protocols, using a food based approach, in a paediatric inpatient eating disorder program. J Eat Disord 1 (Suppl 1), O17 (2013). https://doi.org/10.1186/2050-2974-1-S1-O17
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DOI: https://doi.org/10.1186/2050-2974-1-S1-O17
Keywords
- Energy Intake
- Eating Disorder
- Community Setting
- Hospital Patient
- Cautious Approach