Impact of caloric intake in critically ill patients with, and without, refeeding syndrome: A retrospective study
Open accessAbstract
BACKGROUND & AIMS: Refeeding syndrome comprises metabolic disturbances that occur after the reintroduction of feeding after prolonged fasting. Standard care consists of correcting fluid and electrolytes imbalances. Energy intake during refeeding syndrome is heavily debated. This study addresses the effect of caloric intake on outcome during the management of refeeding syndrome. METHODS: A retrospective study among critically ill invasive mechanically ventilated patients admitted for >7 days to a medical-surgical ICU. Refeeding syndrome was diagnosed by the occurrence of new onset hypophosphatemia (<0.65 mmol/l) within 72 h of the start of nutritional support. Primary outcome was 6-month mortality. Secondary outcomes were 3-month mortality, ICU and hospital length of stay and duration of mechanical ventilation. Outcomes of patients with and without refeeding syndrome were compared and subgroup analysis on energy intake within the refeeding population was performed for the duration of survival. RESULTS: Of 337 enrolled patients, 124 (36.8%) developed refeeding syndrome and 213 patients (63.2%) maintained normal serum phosphate levels. Between the two groups, no statistical significant differences in clinical outcomes were observed. Within the refeeding syndrome group, a reduced 6-month mortality risk for low caloric intake (<50% of target) was seen compared with normal intake, adjusted Hazard Ratio 0.39, (95% CI 0.16-0.95, p = 0.037). In this group, low caloric intake was associated with an increased overall survival time at day 180 (153.0 (SE 10.1) vs 119.1 (SE 8.0) days, log-rank p = 0.018). CONCLUSIONS: Refeeding syndrome is common among prolonged mechanically ventilated critically ill patients, however not predictable by baseline characteristics. Among patients that develop refeeding syndrome low caloric intake was associated with a reduction in 6-month mortality risk. This effect was not seen in patients without refeeding syndrome. Findings support caloric restriction in refeeding syndrome during critical illness.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Blood glucose control targeting a concentration of 6-8 mmol/l has been shown to be associated with improved outcome.
“Blood glucose control is essential, and should target a concentration of 6-8 mmol/l which has been shown to be associated with improved outcome (361,362,363,364,365,366).”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [361]
Electrolyte alterations are less likely to occur with a cautious introduction of feeding, as shown by a recent early calorie restriction study and confirmed by a retrospective study.
“A recent early calorie restriction study showed that electrolyte alterations were less likely to occur with a cautious introduction of feeding and this was confirmed by a retrospective study [149].”
From ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit (2023) · cites this paper as [149]
Cites
Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987) · Journal of Chronic Diseases · doi:10.1016/0021-9681(87)90171-8 · Cited by 49,742 · see citing works
Knaus, W. A., Draper, E. A., Wagner, D. P., & Zimmerman, J. E. (1985) · Critical Care Medicine · doi:10.1097/00003246-198510000-00009 · Cited by 15,333 · see citing works
APACHE II-A Severity of Disease Classification System
Knaus, W. A., Draper, E. A., Wagner, D. P., & Zimmerman, J. E. (1986) · Critical Care Medicine · doi:10.1097/00003246-198608000-00028 · Cited by 13,379 · see citing works
McClave, S. A., Taylor, B. E., Martindale, R. G., Warren, M. M., Johnson, D. R., Braunschweig, C., McCarthy, M. S., Davanos, E., Rice, T. W., Cresci, G. A., et al. (2016) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607115621863 · Cited by 3,982 · see citing works
Vincent, J.-L., de Mendonca, A., Cantraine, F., Moreno, R., Takala, J., Suter, P. M., Sprung, C. L., Colardyn, F., & Blecher, S. (1998) · Critical Care Medicine · doi:10.1097/00003246-199811000-00016 · Cited by 3,463 · see citing works
Refeeding syndrome: what it is, and how to prevent and treat it
Mehanna, H. M., Moledina, J., & Travis, J. (2008) · BMJ · doi:10.1136/bmj.a301 · Cited by 706 · see citing works
The importance of the refeeding syndrome
Crook, M. A., Hally, V., & Panteli, J. V. (2001) · Nutrition · doi:10.1016/s0899-9007(01)00542-1 · Cited by 488 · see citing works
Refeeding Hypophosphatemia in Critically Ill Patients in an Intensive Care Unit
Marik, P. E. (1996) · Archives of Surgery · doi:10.1001/archsurg.1996.01430220037007 · Cited by 333 · see citing works
Stanga, Z. G., Brunner, A., Leuenberger, M., Grimble, R. F., Shenkin, A., Allison, S. P., & Lobo, D. N. (2007) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1602854 · Cited by 313 · see citing works
Doig, G. S., Simpson, F., Heighes, P. T., Bellomo, R., Chesher, D., Caterson, I. D., Reade, M. C., & Harrigan, P. W. J. (2015) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(15)00418-x · Cited by 308 · see citing works
Death resulting from overzealous total parenteral nutrition: the refeeding syndrome revisited.
Weinsier, R., & Krumdieck, C. (1981) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/34.3.393 · Cited by 213 · see citing works
Relationship Between Hyperglycemia and Infection in Critically Ill Patients
Butler, S. O., Btaiche, I. F., & Alaniz, C. (2005) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1592/phco.2005.25.7.963 · Cited by 185 · see citing works
Rio, A., Whelan, K., Goff, L., Reidlinger, D. P., & Smeeton, N. (2013) · BMJ Open · doi:10.1136/bmjopen-2012-002173 · Cited by 181 · see citing works
Severe hypophosphatemia in sepsis as a mortality predictor.
Shor, R., Halabe, A., Rishver, S., Tilis, Y., Matas, Z., Fux, A., Boaz, M., & Weinstein, J. (2006) · PubMed · Cited by 163 · see citing works
Refeeding syndrome: Problems with definition and management
Crook, M. A. (2014) · Nutrition · doi:10.1016/j.nut.2014.03.026 · Cited by 154 · see citing works
Hearing, S. D. (2004) · BMJ · doi:10.1136/bmj.328.7445.908 · Cited by 134 · see citing works
Refeeding hypophosphataemia is more common in enteral than parenteral feeding in adult in patients
Zeki, S. S., Culkin, A., Gabe, S. M., & Nightingale, J. M. D. (2011) · Clinical Nutrition · doi:10.1016/j.clnu.2010.12.001 · Cited by 110 · see citing works
Vignaud, M., Constantin, J.-M., Ruivard, M., Villemeyre-Plane, M., Futier, E., Bazin, J.-E., Annane, D., & AZUREA group (AnorexieRea Study Group) (2010) · Critical Care · doi:10.1186/cc9274 · Cited by 110 · see citing works
Marik, P. E., & Hooper, M. H. (2016) · Intensive Care Medicine · doi:10.1007/s00134-015-4131-4 · Cited by 109 · see citing works
Al-Dorzi, H. M., Albarrak, A., Ferwana, M., Murad, M. H., & Arabi, Y. M. (2016) · Critical Care · doi:10.1186/s13054-016-1539-3 · Cited by 74 · see citing works
Refeeding hypophosphatemia: a potentially fatal danger in the intensive care unit
COŞKUN, R., Gündoğan, K., Baldane, S., Güven, M., & Sungur, M. (2014) · TURKISH JOURNAL OF MEDICAL SCIENCES · doi:10.3906/sag-1211-49 · Cited by 67 · see citing works
Relevance of non-nutritional calories in mechanically ventilated critically ill patients
Bousie, E., van Blokland, D., Lammers, H. J. W., & van Zanten, A. R. H. (2016) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2016.167 · Cited by 65 · see citing works
Incidence of refeeding syndrome in internal medicine patients.
Kraaijenbrink, B. V. C., Lambers, W. M., Mathus-Vliegen, E. M. H., & Siegert, C. E. H. (2016) · PubMed · Cited by 60 · see citing works
Giovannini, I., Chiarla, C., & Nuzzo, G. (2002) · Shock · doi:10.1097/00024382-200208000-00003 · Cited by 51 · see citing works
STARVATION IN WESTERN HOLLAND : 1945
Burger, G. C. E., Sandstead, H. R., & Drummond, J. C. (1945) · The Lancet · doi:10.1016/s0140-6736(45)90738-0 · Cited by 47 · see citing works
Refeeding and metabolic syndromes: two sides of the same coin
Obeid, O., Hachem, D. H., & Ayoub, J. J. (2014) · Nutrition and Diabetes · doi:10.1038/nutd.2014.21 · Cited by 34 · see citing works
López, M. T. F., Otero, M. J. L., Vázquez, P. Á., Delgado, J. A., & Correa, J. J. V. (2009) · Farmacia Hospitalaria · doi:10.1016/s1130-6343(09)72163-4 · Cited by 21 · see citing works
Risk factors of septic shock in patients with hematologic malignancies and Pseudomonas infections
Jeddi, R., Ghédira, H., Amor, R. B., Turki, A., Kacem, K., Abdennebi, Y. B., Lakhal, R. B., Aissaoui, L., Abid, H. B., Hadjali, Z. B., et al. (2011) · Hematology · doi:10.1179/102453311x12953015767293 · Cited by 20 · see citing works
[The occurrence of hypophosphatemia and its prognostic value in intensive care unit patients].
Jia-hong, F., & Zang, B. (2012) · PubMed · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
ESPEN guideline on clinical nutrition in the intensive care unit.
Singer, P., Blaser, A. R., Berger, M. M., Alhazzani, W., Calder, P. C., Casaer, M. P., Hiesmayr, M., Mayer, K., Montejo, J. C., Pichard, C., et al. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2018.08.037 · Cited by 2,904 · see citing works
ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit
Singer, P., Blaser, A. R., Berger, M. M., Calder, P. C., Casaer, M., Hiesmayr, M., Mayer, K., Montejo-Gonzalez, J. C., Pichard, C., Preiser, J.-C., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.07.011 · Cited by 793 · see citing works
ASPEN Consensus Recommendations for Refeeding Syndrome
da Silva, J. S. V., Seres, D. S., Sabino, K., Adams, S. C., Berdahl, G. J., Citty, S. W., Cober, M. P., Evans, D. C., Greaves, J. R., Gura, K. M., et al. (2020) · Nutrition in Clinical Practice · doi:10.1002/ncp.10474 · Cited by 542 · see citing works
van Zanten, A. R. H., Waele, E. D., & Wischmeyer, P. E. (2019) · Critical Care · doi:10.1186/s13054-019-2657-5 · Cited by 348 · see citing works
Monitoring nutrition in the ICU
Berger, M. M., Reintam-Blaser, A., Calder, P. C., Casaer, M., Hiesmayr, M. J., Mayer, K., Montejo, J. C., Pichard, C., Preiser, J.-C., van Zanten, A. R. H., et al. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2018.07.009 · Cited by 171 · see citing works
A guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice
Preiser, J.-C., Arabi, Y. M., Berger, M. M., Casaer, M., McClave, S., Montejo-González, J. C., Peake, S., Reintam Blaser, A., Van den Berghe, G., van Zanten, A., et al. (2021) · Critical Care · doi:10.1186/s13054-021-03847-4 · Cited by 166 · see citing works
Pardo, E., Lescot, T., Preiser, J.-C., Massanet, P., Pons, A., Jaber, S., Fraipont, V., Levesque, E., Ichai, C., Petit, L., et al. (2023) · Critical Care · doi:10.1186/s13054-022-04298-1 · Cited by 116 · see citing works
Management of Refeeding Syndrome in Medical Inpatients
Reber, E., Friedli, N., Vasiloglou, M., Schuetz, P., & Stanga, Z. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8122202 · Cited by 93 · see citing works
The incidence of the refeeding syndrome. A systematic review and meta-analyses of literature
Cioffi, I., Ponzo, V., Pellegrini, M., Evangelista, A., Bioletto, F., Ciccone, G., Pasanisi, F., Ghigo, E., & Bo, S. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.04.023 · Cited by 90 · see citing works
Nutrition in the intensive care unit: from the acute phase to beyond
de Man, A., Gunst, J., & Blaser, A. R. (2024) · Intensive Care Medicine · doi:10.1007/s00134-024-07458-9 · Cited by 94 · see citing works
Preserving the quality of life: nutrition in the ICU
Singer, P. (2019) · Critical Care · doi:10.1186/s13054-019-2415-8 · Cited by 84 · see citing works
Metabolic support in the critically ill: a consensus of 19
Wernerman, J., Christopher, K. B., Annane, D., Casaer, M. P., Coopersmith, C. M., Deane, A. M., Waele, E. D., Elke, G., Ichaï, C., Karvellas, C. J., et al. (2019) · Critical Care · doi:10.1186/s13054-019-2597-0 · Cited by 84 · see citing works
Ponzo, V., Pellegrini, M., Cioffi, I., Scaglione, L., & Bo, S. (2020) · Internal and Emergency Medicine · doi:10.1007/s11739-020-02525-7 · Cited by 78 · see citing works
Toward nutrition improving outcome of critically ill patients: How to interpret recent feeding RCTs?
Gunst, J., Casaer, M. P., Preiser, J., Reignier, J., & den Berghe, G. V. (2023) · Critical Care · doi:10.1186/s13054-023-04317-9 · Cited by 77 · see citing works
Refeeding Syndrome in the Critically Ill: a Literature Review and Clinician’s Guide
McKnight, C. L., Newberry, C. A., Sarav, M., Martindale, R. G., Hurt, R. T., & Daley, B. J. (2019) · Current Gastroenterology Reports · doi:10.1007/s11894-019-0724-3 · Cited by 75 · see citing works
Autophagy and Its Implications Against Early Full Nutrition Support in Critical Illness
Van Dyck, L., Casaer, M. P., & Gunst, J. (2018) · Nutrition in Clinical Practice · doi:10.1002/ncp.10084 · Cited by 70 · see citing works
Hypophosphatemia in critically ill adults and children – A systematic review
Blaser, A. R., Gunst, J., Ichaï, C., Casaer, M. P., Benstoem, C., Besch, G., Dauger, S., Fruhwald, S. M., Hiesmayr, M., Joannès-Boyau, O., et al. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.09.045 · Cited by 69 · see citing works
Examining the Role of Anxiety and Depression in Dietary Choices among College Students
Keck, M. M., Vivier, H., Cassisi, J. E., Dvorak, R. D., Dunn, M. E., Neer, S. M., & Ross, E. J. (2020) · Nutrients · doi:10.3390/nu12072061 · Cited by 71 · see citing works
Ballesteros, M. Á., Hernández-Tejedor, A., Estella, Á., Rivera, J. J. J., de Molina, F. J. G., Camps, A. S., Vidal, P., de Haro, C., Aguilar-Alonso, E., Laguna, L. B., et al. (2020) · Medicina Intensiva · doi:10.1016/j.medin.2020.04.001 · Cited by 65 · see citing works
Obesity and critical care nutrition: current practice gaps and directions for future research
Dickerson, R. N., Andromalos, L., Brown, J. C., Correia, M. I. T. D., Pritts, W., Ridley, E. J., Robinson, K. N., Rosenthal, M. D., & van Zanten, A. R. H. (2022) · Critical Care · doi:10.1186/s13054-022-04148-0 · Cited by 61 · see citing works
Refeeding syndrome: relevance for the critically ill patient
Slingerland-Boot, R., Koekkoek, K. W. A. C., & van Zanten, A. R. H. (2018) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000000514 · Cited by 56 · see citing works
Micronutrient deficiency in critical illness: an invisible foe?
Casaer, M. P., & Bellomo, R. (2019) · Intensive Care Medicine · doi:10.1007/s00134-019-05678-y · Cited by 49 · see citing works
Reignier, J., Roux, B. G., Dequin, P. F., Maluf, V. A. B., Bohé, J., Casaer, M. P., Delbove, A., Dupuis, C., Fontaine, E. M., Gamon, P., et al. (2025) · Annals of Intensive Care · doi:10.1186/s13613-025-01509-0 · Cited by 53 · see citing works
The Japanese Critical Care Nutrition Guideline 2024
Nakamura, K., Yamamoto, R., Higashibeppu, N., Yoshida, M., Tatsumi, H., Shimizu, Y., Izumino, H., Oshima, T., Hatakeyama, J., Ouchi, A., et al. (2025) · Journal of Intensive Care · doi:10.1186/s40560-025-00785-z · Cited by 50 · see citing works
Vankrunkelsven, W., Gunst, J., Amrein, K., Bear, D., Berger, M., Christopher, K., Fuhrmann, V., Hiesmayr, M., Ichai, C., Jakob, S., et al. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.06.005 · Cited by 33 · see citing works
Incidence and outcome of refeeding syndrome in neurocritically ill patients
Xiong, R., Huang, H., Wu, Y., Wang, S., Wang, D., Ji, Z., Lin, Z., Zang, N., Pan, S., & Huang, K. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.06.038 · Cited by 41 · see citing works
The science of micronutrients in clinical practice – Report on the ESPEN symposium
Berger, M. M., Amrein, K., Barazzoni, R., Bindels, L. B., Lesmes, I. B., Calder, P. C., Cappa, S. F., Cuerda, C., D’Amelio, P., de Man, A., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.12.006 · Cited by 41 · see citing works
Muscle Mass Loss in the Older Critically Ill Population: Potential Therapeutic Strategies
McKendry, J., Thomas, A. C. Q., & Phillips, S. M. (2020) · Nutrition in Clinical Practice · doi:10.1002/ncp.10540 · Cited by 38 · see citing works
Sanz, M. Á. B., Hernández-Tejedor, A., Estella, Á., Rivera, J. J. J., Ortiz, F. J. G. D. M., Camps, A. S., Cortés, P. V., de Haro, C., Aguilar-Alonso, E., Laguna, L. B., et al. (2020) · Medicina Intensiva (English Edition) · doi:10.1016/j.medine.2020.04.003 · Cited by 36 · see citing works
Yoshida, M., Izawa, J., Wakatake, H., Saito, H., 千壽, 川., Matsushima, S., Suzuki, A. S., Nagatomi, A., Yoshida, T., Masui, Y., et al. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.07.034 · Cited by 34 · see citing works
Zonies, D. H., Codner, P. A., Park, P. K., Martin, N. D., Lissauer, M. E., Evans, S. L., Cocanour, C. S., & Brasel, K. J. (2019) · Trauma Surgery & Acute Care Open · doi:10.1136/tsaco-2019-000304 · Cited by 33 · see citing works
Wang, C.-Y., Fu, P., Chao, W., Wang, W.-N., Chen, C., & Huang, Y. (2020) · Nutrients · doi:10.3390/nu12113518 · Cited by 33 · see citing works
Enteral nutrition in hospitalized adults
Gramlich, L., & Guenter, P. (2025) · New England Journal of Medicine · doi:10.1056/nejmra2406954 · Cited by 30 · see citing works
Refeeding Syndrome: A Critical Reality in Patients with Chronic Disease
Krutkyte, G., Wenk, L., Odermatt, J., Schuetz, P., Stanga, Z., & Friedli, N. (2022) · Nutrients · doi:10.3390/nu14142859 · Cited by 29 · see citing works
Pantoja, F., Fragkos, K. C., Patel, P. S., Keane, N., Samaan, M., Barnova, I., Caro, S. D., Mehta, S. J., & Rahman, F. Z. (2018) · Clinical Nutrition · doi:10.1016/j.clnu.2018.06.967 · Cited by 27 · see citing works
Matthews-Rensch, K., Blackwood, K., Lawlis, D., Breik, L., McLean, C., Nguyen, T., Phillips, S., Small, K., Stewart, T., Thatcher, A., et al. (2025) · Nutrition & Dietetics · doi:10.1111/1747-0080.70003 · Cited by 24 · see citing works
Lugli, A. K., de Watteville, A., Hollinger, A., Goetz, N., & Heidegger, C. P. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8091395 · Cited by 26 · see citing works
Understanding Refeeding Syndrome in Critically Ill Patients: A Narrative Review
Borriello, R., Esposto, G., Ainora, M. E., Podagrosi, G., Ferrone, G., Mignini, I., Galasso, L., Gasbarrini, A., & Zocco, M. A. (2025) · Nutrients · doi:10.3390/nu17111866 · Cited by 26 · see citing works
Meira, A. P. C., Santos, C. O. D., Lucho, C. L. C., Kasmirscki, C., & Silva, F. M. (2020) · Nutrition in Clinical Practice · doi:10.1002/ncp.10563 · Cited by 22 · see citing works
Ribeiro, A. C., Dock‐Nascimento, D. B., Silva, J. M., Caporossi, C., & de Aguilar‐Nascimento, J. E. (2020) · Revista da Associação Médica Brasileira · doi:10.1590/1806-9282.66.9.1241 · Cited by 22 · see citing works
Bioletto, F., Pellegrini, M., Ponzo, V., Cioffi, I., Francesco, A. D., Ghigo, E., & Bo, S. (2021) · The American Journal of Medicine · doi:10.1016/j.amjmed.2021.03.010 · Cited by 22 · see citing works
Refeeding syndrome—diagnostic challenges and the potential of clinical decision support systems
Heuft, L., Voigt, J., Selig, L., Stümvoll, M., Schlögl, H., & Kaiser, T. (2023) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2022.0381 · Cited by 22 · see citing works
Refeeding syndrome in the gastroenterology practice: how concerned should we be?
Nunes, G. F. D., Brito, M., Santos, C. A., & Fonseca, J. (2018) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000001202 · Cited by 22 · see citing works
Impact of early high protein intake in critically ill patients: a randomized controlled trial
Wang, Y., Ye, Y., Xuan, L., Xu, L., Wang, P., Ma, J., Wang, Y., Chen, Y., Miao, J., Wang, W., et al. (2024) · Nutrition & Metabolism · doi:10.1186/s12986-024-00818-8 · Cited by 24 · see citing works
Liu, N., Zhao, X.-L., Xiong, R., Chen, Q., Wu, Y., Lin, Z.-Z., Wang, S.-N., Wu, T., Pan, S.-Y., & Huang, K. (2022) · Nutrients · doi:10.3390/nu14194032 · Cited by 15 · see citing works
Le concept du « Baby stomach » appliqué à la nutrition du patient agressé
Preiser, J., Fraipont, V., & Lheureux, O. (2019) · Nutrition Clinique et Métabolisme · doi:10.1016/j.nupar.2019.05.003 · Cited by 18 · see citing works
Zauner, C., Schneeweiss, M., Schmid, M., & Wewalka, M. (2020) · Journal für Gastroenterologische und Hepatologische Erkrankungen · doi:10.1007/s41971-020-00069-3 · Cited by 5 · see citing works
Padelli, M., Aubron, C., Huet, O., Héry-Arnaud, G., Vermeersch, V., Hoffmann, C. V., Bettacchioli, É., Maguet, H., Carré, J., & Leven, C. (2020) · Australian Critical Care · doi:10.1016/j.aucc.2020.05.001 · Cited by 17 · see citing works
Schneeweiss-Gleixner, M., Haselwanter, P., Schneeweiss, B., Zauner, C., & Riedl-Wewalka, M. (2024) · Nutrients · doi:10.3390/nu16070922 · Cited by 16 · see citing works
Risk factors for the development of refeeding syndrome in adults: A systematic review
Zheng, P., Chen, Y., Chen, F., Zhou, M., & Xie, C. (2024) · Nutrition in Clinical Practice · doi:10.1002/ncp.11203 · Cited by 16 · see citing works
Briassoulis, G. C., Ilia, S., & Briassouli, E. (2024) · Nutrients · doi:10.3390/nu16203523 · Cited by 17 · see citing works
Deane, A. M., Jiang, A. C., Tascone, B., Clancy, A., Finnis, M., Collie, J. T. B., Greaves, R. F., Byrne, K. M., Fujii, T., Douglas, J. S., et al. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.07.024 · Cited by 15 · see citing works
dos Santos, D. C., Ataide, C. D. G., da Costa, N. M., Junior, V. P. D. O., & Egea, M. B. (2021) · Nutrition Reviews · doi:10.1093/nutrit/nuab121 · Cited by 15 · see citing works
Li, J., Lu, K., Zhang, X., Wang, T., Li, Q., Yu, X., Han, W., & Sun, L. (2022) · Annals of Translational Medicine · doi:10.21037/atm-22-222 · Cited by 14 · see citing works
Veldscholte, K., Veen, M. A. N., Eveleens, R. D., de Jonge, R. C. J., Vanhorebeek, I., Gunst, J., Casaer, M. P., Wouters, P. J., Guerra, G. G., den Berghe, G. V., et al. (2022) · Clinical Nutrition · doi:10.1016/j.clnu.2022.09.001 · Cited by 13 · see citing works
Macronutrient intake and outcomes of ICU patients with refeeding hypophosphatemia
Slingerland-Boot, R., Rooijakkers, E. P. E. M., Koekkoek, K. W. A. C., van Blokland, D. A., Arbous, M. S., & van Zanten, A. R. H. (2023) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2023.03.003 · Cited by 13 · see citing works
Electrolyte disorders during the initiation of nutrition therapy in the ICU
Blaser, A. R., & van Zanten, A. R. H. (2020) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000000730 · Cited by 13 · see citing works
Alencar, L. D. O., Neto, J. E. F., Beserra, E. A., & Mendes, J. F. R. (2024) · Nutrition · doi:10.1016/j.nut.2024.112562 · Cited by 12 · see citing works
Lauwers, C., Langouche, L., Wouters, P. J., Wilmer, A. P., den Berghe, G. V., Casaer, M. P., & Gunst, J. (2025) · Critical Care · doi:10.1186/s13054-025-05273-2 · Cited by 14 · see citing works
Development and validation of risk prediction model for refeeding syndrome in neurocritical patients
Zhang, W., Zhang, S., Chen, S.-F., Yu, T., & Tang, Y. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2023.1083483 · Cited by 11 · see citing works
Bischoff, S. C., Arends, J., Decker-Baumann, C., Hütterer, E., Koch, S., Mühlebach, S., Rötzer, I., Schneider, A. S., Seipt, C., Simanek, R., et al. (2024) · Aktuelle Ernährungsmedizin · doi:10.1055/a-2270-7667 · Cited by 11 · see citing works
Tongyoo, S., Rawangban, P., & Naorungroj, T. (2024) · Nutrition in Clinical Practice · doi:10.1002/ncp.11160 · Cited by 11 · see citing works
Ambrose, T., Silva, A. D., Naghibi, M., Saunders, J. A., Smith, T. R., Coleman, R. L., & Stroud, M. A. (2021) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2020.11.028 · Cited by 11 · see citing works
Refeeding syndrome in hematological cancer patients – current approach
Szeja, N., & Grosicki, S. (2020) · Expert Review of Hematology · doi:10.1080/17474086.2020.1727738 · Cited by 11 · see citing works
Trophic or full nutritional support?
Arabi, Y. M., & Al‐Dorzi, H. M. (2018) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000000508 · Cited by 11 · see citing works
Trace element and vitamin deficiency: quantum medicine or essential prescription?
Berger, M. M., & Ben‐Hamouda, N. (2020) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000000737 · Cited by 10 · see citing works
Ben-Tovim, H., & Theilla, M. (2021) · Intensive and Critical Care Nursing · doi:10.1016/j.iccn.2021.103097 · Cited by 10 · see citing works
Simeunovic-Ostojic, M., Maas, J., & Bodde, N. M. G. (2021) · Journal of Eating Disorders · doi:10.1186/s40337-021-00369-w · Cited by 9 · see citing works
Liu, P., Chen, L., Zhong, T., Zhang, M., Ma, T., & Tian, H. (2022) · Clinical Nutrition · doi:10.1016/j.clnu.2022.07.023 · Cited by 9 · see citing works
Ergül, S. Ş., Şahin, G. G., Özer, N. T., Kaynar, L., Çelik, S., & Gündoğan, K. (2022) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2022.07.014 · Cited by 9 · see citing works
Yaroshetskiy, A. I., Konanykhin, V. D., Stepanova, S. O., & Резепов, Н. А. (2019) · Annals of critical care · doi:10.21320/1818-474x-2019-2-82-91 · Cited by 9 · see citing works
Recent advances in refeeding syndrome in critically ill patients: a narrative review
Ha, S. W., & Hong, S. (2024) · 한국정맥경장영양학회지 · doi:10.15747/acnm.2024.16.1.3 · Cited by 8 · see citing works
Dock-Nascimento, D. B., Ribeiro, A., Silva, J. J., & de Aguilar-Nascimento, J. E. (2023) · Archives of Medical Research · doi:10.1016/j.arcmed.2023.02.005 · Cited by 6 · see citing works
Bernardes, S., Stello, B. B., Milanez, D. S. J., Razzera, E. L., & Silva, F. M. (2024) · Intensive and Critical Care Nursing · doi:10.1016/j.iccn.2024.103716 · Cited by 9 · see citing works
Statlender, L., Raphaeli, O., Shochat, T., Robinson, E., Itzhaki, M. H., Bendavid, I., Fishman, G., Singer, P., & Kagan, I. (2024) · Scientific Reports · doi:10.1038/s41598-024-68688-x · Cited by 8 · see citing works
Hypophosphatemia in critically ill pediatric patients receiving enteral and oral nutrition
Springer, A. M. D. M., Hortêncio, T. D. R., Melro, E. C., de Souza, T. H., & Nogueira, R. J. N. (2021) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.2235 · Cited by 8 · see citing works
LLL 44-4 : Micronutrients in acute disease and critical illness
de Man, A., Amrein, K., Casaer, M. P., Dizdar, O. S., van Zanten, A. R. H., Gündoğan, K., Lepp, H.-L., Rezzi, S., Shenkin, A., & Berger, M. M. (2024) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2024.04.011 · Cited by 7 · see citing works
Refeeding Hypophosphatemia in Oldest Old Critically Ill Patients
Ferliçolak, L., & Altıntaş, N. D. (2023) · Irish Journal of Medical Science (1971 -) · doi:10.1007/s11845-023-03498-0 · Cited by 7 · see citing works
Changing paradigms in metabolic support and nutrition therapy during critical illness
van Zanten, A. R. H. (2018) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000000519 · Cited by 7 · see citing works
Nguyen, P., Schlögl, H., Selig, L., & Baerwald, C. (2020) · Zeitschrift für Rheumatologie · doi:10.1007/s00393-020-00952-7 · Cited by 7 · see citing works
Olsen, S. U., Hesseberg, K., Aas, A.-M., Pripp, A., Ranhoff, A., & Bye, A. (2021) · European Geriatric Medicine · doi:10.1007/s41999-021-00520-5 · Cited by 5 · see citing works
Protective nutrition strategy in the acute phase of critical illness: why, what and how to protect
Wang, Y., Li, Y., Li, N., Li, Y., Li, H., & Zhang, D. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1555311 · Cited by 6 · see citing works
Melchers, M., Kouw, I. W. K., Arabi, Y. M., Casaer, M. P., Cotoia, A., Gunst, J., Malbrain, M. L. N. G., Schaller, S. J., Starkopf, J., Rehal, M. S., et al. (2024) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2024.07.024 · Cited by 6 · see citing works
Risk factors and outcomes for refeeding syndrome in acute ischaemic stroke patients
Chen, S., Cai, D., Lai, Y., Zhang, Y., He, J., Zhou, L. F., & Sun, H. (2024) · Nutrition & Dietetics · doi:10.1111/1747-0080.12872 · Cited by 5 · see citing works
Sundström, N., Brorsson, C., Karlsson, M., Wiklund, U., & Koskinen, L. (2020) · Journal of Clinical Monitoring and Computing · doi:10.1007/s10877-020-00513-y · Cited by 5 · see citing works
Petit, L., Faure, N., Pereira, B., Dubuisson, V., Bérard, X., Biais, M., & Carrié, C. (2024) · Journal of Abdominal Wall Surgery · doi:10.3389/jaws.2024.13702 · Cited by 4 · see citing works
Zhan, X., Wang, H., & Bai, Y. (2025) · International Journal of General Medicine · doi:10.2147/ijgm.s544989 · Cited by 4 · see citing works
Schneider, L., Nedel, W. L., Perez, A. V., Sei, L. J. C., Silveira, R. C., Viana, M. V., & Rech, T. H. (2026) · Scientific Reports · doi:10.1038/s41598-026-41063-8 · Cited by 5 · see citing works
Hortêncio, T. D. R., Springer, A. M. D. M., Silveira, L. R., Golucci, A. P. B. S., Filho, R. M. S., & Nogueira, R. J. N. (2025) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2025.04.023 · Cited by 4 · see citing works
Colmenero, M., Morón, R., de Dios-Chacón, I., Fernández-Morales, P., Vera, M. R. M., & Manzano, F. (2024) · Medicina Intensiva · doi:10.1016/j.medin.2023.12.002 · Cited by 4 · see citing works
Lheureux, O., & Preiser, J. (2019) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000000626 · Cited by 4 · see citing works
Pérsico, R. S., & Franzosi, O. S. (2021) · Nutrición Hospitalaria · doi:10.20960/nh.03500 · Cited by 3 · see citing works
Colmenero, M., Morón, R., de Dios-Chacón, I., Fernández-Morales, P., Vera, M. R. M., & Manzano, F. (2024) · Medicina Intensiva (English Edition) · doi:10.1016/j.medine.2024.01.004 · Cited by 3 · see citing works
Nutrition in Critically Ill Patients
Jensen, C. (2022) · Physician Assistant Clinics · doi:10.1016/j.cpha.2022.05.006 · Cited by 3 · see citing works
Optimising early nutritional support for medical inpatients.
Casaer, M., den Berghe, G. V., & Gunst, J. (2019) · The Lancet · doi:10.1016/s0140-6736(19)32467-5 · Cited by 2 · see citing works
Nutrition in the critically ill patient
Koekkoek, W. A. C. (2023) · doi:10.33540/1675 · Cited by 3 · see citing works
Self-citationSingapore clinical guideline on parenteral nutrition in adult patients in the acute hospital setting
Lum, J. H. M., Yeong, H. E. L., Tan, P. E., Salazar, E., Lee, T., Ng, Y. C., Chong, J. N. C., Wong, P. W., Ong, J. P. L., Gooi, S. C., et al. (2025) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmedsg.2024318 · Cited by 2 · see citing works
Feeding-associated hypophosphatemia in critically ill patients. A multicentre, observational study
Chaba, A., Doola, R., Laupland, K. B., Shekar, K., Kumar, A., Tabah, A., Ramanan, M., Edwards, F., Bellomo, R., & White, K. C. (2025) · Journal of Critical Care · doi:10.1016/j.jcrc.2025.155400 · Cited by 3 · see citing works
Vanhorebeek, I., Serin, N. U., Güiza, F., Mebis, L., Verbruggen, S. C. A. T., Joosten, K. F. M., den Berghe, G. V., & Gunst, J. (2026) · Critical Care · doi:10.1186/s13054-026-05844-x · Cited by 2 · see citing works
Bezerra, A. R., dos Santos, P. A. A., Santos, L. S., & Petribú, M. D. M. V. (2021) · DEMETRA Alimentação Nutrição & Saúde · doi:10.12957/demetra.2021.53791 · Cited by 2 · see citing works
- Authors
- Olthof, L. E., Koekkoek, W. A. C. K., van Setten, C., Kars, J. C. N., van Blokland, D., & van Zanten, A. R. H.
- Affiliations
- Ziekenhuis Gelderse Vallei (NL)
- Corresponding author
- Olthof, Laura E.
- Koekkoek, W.A.C. Kristine
- Kars, Johannes C.N.
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2018-10
- Volume
- 37
- Issue
- 5
- Pages
- 1609-1617
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2744223015
- Cited by
- 156
- References
- 29
- Citations by year
- 2026: 15 · 2025: 15 · 2024: 24 · 2023: 15 · 2022: 11 · 2021: 23 · 2020: 24 · 2019: 15 · 2018: 13
- FWCI
- 11.83
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Nutrition (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Keywords
- refeeding syndrome, energy intake, caloric restriction, critically ill patients, mechanical ventilation, hypophosphatemia, nutritional support, mortality, length of hospital stay, prolonged fasting
- MeSH terms
- Aged, Aged, 80 and over, Energy Intake, Female, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Phosphates, Respiration, Artificial, Retrospective Studies, Critical Illness, Treatment Outcome, Hypophosphatemia, Nutritional Support, Caloric Restriction, Refeeding Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
