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Recognizing Neonatal Refeeding Syndrome and Thiamine Supplementation: A Case Report.

BACKGROUND: Refeeding syndrome (RS) is a condition characterized by electrolyte derangements, thiamine deficiency, and organ dysfunction following provision of nutrition to an individual who had been deprived of nutrients. Published guidelines outlining the recognition and definition of RS exist in adult and children, but there are limited newborn-specific guidelines due to a paucity of available literature and variation in reporting.

CASE: We describe a small for gestational age, full-term newborn with neonatal encephalopathy who underwent therapeutic hypothermia. Electrolyte derangements and lactic acidosis developed and persisted following introduction of intravenous nutrition. After exclusion of other etiologies, neonatal RS was suspected, and the newborn was treated with thiamine.

CONCLUSIONS: We provide a brief review of the current literature on neonatal RS, present a case report consistent with neonatal RS, and provide suggestions for the utility of thiamine replacement in newborns with suspected neonatal RS. This article is protected by copyright. All rights reserved.

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