Risk factors
Mnemonic: ABCD
Pathophysiology
Mnemonic: PPM
Malnourished (depleted intracellular Phosphate, Potassium, M agnesium) → Refeeding → Increased glucose load → Insulin spikes → Drives PPM into cells → Hypophosphatemia (major abnormality), hypokalemia, hypomagnesemia
Prevention
If patient hasn't not eaten for >5 days, aim to refeed at <50% energy and protein levels.
Monitor and aggresively supplement PPM.