Management

Paediatric guidelines (in development)
NHS Lothian
  • Order bloods: order set "Refeeding Syndrome Screen RHCYP" (U&E's, Cr, PO4, Mg, Ca) and a CRP
  • Replace serum electrolytes if low; see table 4
  • Prescribe vitamin B1 (thiamine/Pabrinex®) replacement prior to feeding and continue for 10 days

Oral / enteral medications?

Thiamine:

≤ 6 years: 50mg TDS

> 6 years: 100mg TDS

Micronutrient supplementation:

Under 6 years of age: Abidec® 0.6ml OD

Between 6 and 12 years: Forceval Junior® 1 tablet dissolved in water OD

Over 12 years: Forceval® 1 capsule OD one hour after meal

IV medications?

See Appendix 3 for HEPMA example

Pabrinex® Ampoules 1 and 2

< 6 yrs: 1ml of each plus 3ml infusion fluid*

6-10 yrs: 2ml each plus 6ml infusion fluid*

10-14 yrs: 3ml of each plus 9ml infusion fluid*

>14 yrs: 5ml of each plus 15ml infusion fluid*

Infusion over 30 minutes once daily

*Compatible infusion fluids: glucose 5%, glucose 4% and sodium chloride 0.18%, glucose 5% with potassium 0.3% Hartmann's solution (compound sodium lactate) sodium chloride 0.9%