Which electrolyte should be monitored in patients experiencing refeeding syndrome?

Monitoring phosphorus levels in patients experiencing refeeding syndrome is crucial because this condition typically occurs when feeding is resumed in individuals who have been malnourished or are in a state of starvation. During refeeding, the reintroduction of carbohydrates stimulates insulin secretion, which promotes cellular uptake of electrolytes and essential nutrients, including phosphate.

In cases of refeeding syndrome, patients can rapidly deplete their phosphorus stores, leading to hypophosphatemia, which can have serious consequences, such as neurological disturbances, muscle weakness, respiratory failure, and myocardial dysfunction. Recognizing and managing the risk of low phosphorus is essential to prevent these complications and ensure safe and effective nutritional rehabilitation.

While potassium, calcium, and magnesium are also important electrolytes to monitor in various clinical situations, the primary concern specific to refeeding syndrome is the level of phosphorus due to its critical role in energy production and cellular metabolism.