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[Patients at risk of malnutrition: assessment of 11 cases of severe malnutrition with individualised total parenteral nutrition].

OBJECTIVE
To describe and assess the efficacy and safety of individualised nutritional support during the first week of total parenteral nutrition in moderately to severely malnourished patients who are susceptible to the refeeding syndrome.


METHOD
Retrospective observational study carried out between January 2003 and June 2006, including adult patients with moderate to severe malnutrition who received = 5 days total parenteral nutrition. The nutritional support was described and the appearance of severe hydroelectrolytic and metabolic disturbances were assessed during the first week of nutrition.


RESULTS
The study included 11 patients with a mean body mass index of 15.4 kg/m2. These patients received an average of 23 Kcal/kg/day. They did not show any signs of severe hydroelectrolytic or metabolic disturbances. Three patients presented with hypophosphataemia, five with hypokalaemia and four with hypomagnesaemia, all of which were mild to moderate and with the exception of two cases, all were corrected within one week of feeding.


CONCLUSIONS
Individualised nutritional support in moderately to severely malnourished patients does not produce refeeding syndrome. Individualised nutrition is an essential strategy for avoiding complications associated with overfeeding.