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Title: A prospective cohort study of patients started on parenteral nutrition; their biochemical markers and risk factors for refeeding hypophosphataemia.
Author: Marvin, Vanessa Ann
ISNI:       0000 0001 3620 4759
Awarding Body: University of Portsmouth
Current Institution: University of Portsmouth
Date of Award: 2007
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Introduction Refeeding syndrome has been recognised for over half a century as a phenomenon that afflicts severely malnourished patients. It has been the cause of significant morbidity and mortality largely through cardiac and neurological manifestations of hypophosphataemia. Though it is well documented in certain populations, refeeding hypophosphataemia may be overlooked and under-diagnosed in hospital inpatients on parenteral nutrition. This could be because of a lack of appropriate biochemical monitoring and an assumption that 'modem' parenteral nutrition regimens contain optimal proportions of minerals and other nutrients to prevent hypophosphataemia It was important to find out who was at risk and what rates of feeding and phosphate infusion are required in parenterally fed patients. Guidelines for staff involved with monitoring and caring for those at risk receiving parenteral nutrition were needed. Method. A cohort of all patients started on total parenteral nutrition was prospectively recruited· between November 2002 and May 2005. Serial serum phosphate levels, and details on other· biochemistry, dietary and medicines intake were collated. Patients in the cohort who developed moderate or severe refeeding hypophosphataemia (a fall in serum phosphate to 0.65 mmol/litre or less) were recruited as cases and matched for age with controls who did not Paired cases and controls were examined to see whether any attributes or risk factors for hypophosphataemia could be identified. Logistic regression to arialyse the effect ofmultiple potential risk factor variables was perfonned. Results Refeeding hypophosphataemia « 0.8mmol/litre) was found in 39.3 per cent of the cohort (n = 275). Seventy patients fulfilled the criteria for cases and were matched with 70.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available