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Eur Arch Otorhinolaryngol. 2018 May;275(5):1049-1058. doi: 10.1007/s00405-018-4935-2. Epub 2018 Mar 22.

Malnutrition and refeeding syndrome prevention in head and neck cancer patients: from theory to clinical application.

Author information

1
Otolaryngology Department, Grenoble Alpes University Hospital, Grenoble, France. akil.kaderbay@gmail.com.
2
Grenoble Alpes University, Grenoble, France. akil.kaderbay@gmail.com.
3
UGA/Inserm U1205, Braintech Lab, Grenoble, France. akil.kaderbay@gmail.com.
4
Otolaryngoloy Department of Grenoble Alpes University Hospital, Hôpital Nord Michallon, CS 10217, 38043, Grenoble Cedex 9, France. akil.kaderbay@gmail.com.
5
Otolaryngology Department, Grenoble Alpes University Hospital, Grenoble, France.
6
Grenoble Alpes University, Grenoble, France.
7
UGA/UMR/CNRS 5309/Inserm 1209, Institut Albert Bonniot, Grenoble, France.
8
Otolaryngoloy Department of Grenoble Alpes University Hospital, Hôpital Nord Michallon, CS 10217, 38043, Grenoble Cedex 9, France.
9
Nutrition Department, Grenoble Alpes University Hospital, Grenoble, France.
10
UGA/Inserm U1055, Grenoble, France.

Abstract

PURPOSE:

The goal of this review is to raise awareness about refeeding syndrome (RFS) and to give a comprehensive presentation of recent guidelines and latest scientific data about nutritional management among head and neck cancer (HNC) patients while focusing on RFS prevention.

METHODS:

A review of literature for nutritional assessment and RFS management was conducted. Electronic searches of Medline, Cochrane, PubMed and Embase databases for articles published in peer-reviewed journals were conducted from February to September 2017 using the keywords: "nutrition assessment", "head and neck cancer", "refeeding syndrome" and "guidelines". Articles, reviews, book references as well as national and international guidelines in English and French were included.

RESULTS:

The prevalence of malnutrition is high in HNC patients and a large number of them will need artificial nutritional support or refeeding intervention. RFS is characterized by fluid and electrolyte imbalance associated with clinical manifestations induced by rapid refeeding after a period of malnutrition or starvation. Regarding risk factors for malnutrition and RFS, HNC patients are particularly vulnerable. However, RFS remains unrecognized among head and neck surgeons and medical teams. Practical data are summarized to help organizing nutritional assessment and refeeding interventions. It also summarizes preventive measures to reduce RFS incidence and morbidity in HNC population.

CONCLUSION:

Nutritional assessment and early refeeding interventions are crucial for HNC patients care. As prevention is the key for RFS management, early identification of patients with high risks is crucial and successful nutritional management requires a multidisciplinary approach.

KEYWORDS:

Head and neck cancer; Malnutrition; Nutritional assessment; Refeeding syndrome

PMID:
29569135
DOI:
10.1007/s00405-018-4935-2
[Indexed for MEDLINE]

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