NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Peter Weijs and Stephen A. McClaveIs refeeding syndrome relevant for critically ill patients?Koekkoek, Wilhelmina A.C.a; Van Zanten, Arthur R.H.aAuthor Information aDepartment of Intensive Care, Gelderse Vallei Hospital, Ede, The Netherlands Correspondence to Arthur R.H. Van Zanten, MD, PhD, Internist-intensivist, Hospital Medical Director, Department of Intensive Care, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, The Netherlands. Tel: +31 318 43 41 15; fax: +31 318 43 41 16; e-mail: firstname.lastname@example.org Current Opinion in Clinical Nutrition and Metabolic Care: March 2018 - Volume 21 - Issue 2 - p 130-137 doi: 10.1097/MCO.0000000000000449 Buy Metrics Abstract Purpose of review To summarize recent relevant studies regarding refeeding syndrome (RFS) in critically ill patients and provide recommendations for clinical practice. Recent findings Recent knowledge regarding epidemiology of refeeding syndrome among critically ill patients, how to identify ICU patients at risk, and strategies to reduce the potential negative impact on outcome are discussed. Summary RFS is a potentially fatal acute metabolic derangement that ultimately can result in marked morbidity and even mortality. These metabolic derangements in ICU patients differ from otherwise healthy patients with RFS, as there is lack of anabolism. This is because of external stressors inducing a hypercatabolic response among other reasons also reflected by persistent high glucagon despite initiation of feeding. Lack of a proper uniform definition complicates diagnosis and research of RFS. However, refeeding hypophosphatemia is commonly encountered during critical illness. The correlations between risk factors proposed by international guidelines and the occurrence of RFS in ICU patients remains unclear. Therefore, regular phosphate monitoring is recommended. Based on recent trials among critically ill patients, only treatment with supplementation of electrolytes and vitamins seems not sufficient. In addition, caloric restriction for several days and gradual increase of caloric intake over days is recommendable. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.