The online version of this article (doi:10.1186/cc9274) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
MV and JMC participated in the design of the study, carried out the study and drafted the manuscript. MR, MVP, EF and JEB participated in the design of the study and data analysis. DA participated in the design of the study and helped to draft the manuscript. All authors read and approved the final manuscript.
Data on the epidemiology and management of anorexia nervosa (AN) in the intensive care unit (ICU) are scarce. The aim of this study was to evaluate the prevalence and associated morbidity and mortality of AN in French ICUs.
We randomly selected 30 ICUs throughout France. Thereafter, we retrospectively analyzed all patients with AN admitted to any of these 30 ICUs between May 2006 and May 2008. We considered demographic data, diagnosis at admission and complications occurring during the stay, focusing on refeeding syndrome and management of refeeding.
Eleven of the 30 ICUs participated in the retrospective study, featuring 68 patients, including 62 women. Average body mass index at the admission was 12 ± 3 kg/m2. Twenty one were mechanically ventilated, mainly for neurological reasons. The reported average calorie intake was 22.3 ± 13 kcal/kg/24 h. Major diagnoses at admission were metabolic problems, refeeding survey and voluntary drug intoxication and infection. The most common complications were metabolic, hematological, hepatic, and infectious events, of which 10% occurred during refeeding. Seven patients developed refeeding syndrome. At day one, the average calorie intake was higher for patients who developed refeeding syndrome (23.2 ± 5 Kcal/kg/j; n = 7) versus patients without refeeding syndrome (14.1 ± 3 Kcal/kg/j; n = 61) P = 0.02. Seven patients died, two from acute respiratory distress syndrome and five from multiorgan-failure associated with major hydroelectrolytic problems.
The frequency of AN in ICU patients is very low and the crude mortality in this group is about 10%. Prevention and early-detection of refeeding syndrome is the key point.
Authors’ original file for figure 113054_2010_8663_MOESM1_ESM.pdf
Walsh BT, Kaplan AS, Attia E, Olmsted M, Parides M, Carter JC, Pike KM, Devlin MJ, Woodside B, Roberto CA, Rockert W: Fluoxetine after weight restoration in anorexia nervosa: a randomized controlled trial. JAMA 2006, 295: 2605-2612. 10.1001/jama.295.22.2605 PubMed
Miller JJ 3rd, Ammerman S, Parker BR: Anorexia nervosa presenting as a peripheral vasculopathy in an adolescent male. J Rheumatol 1995, 22: 544-547. PubMed
National Institute for Health and Clinical Excellence: Nutrition support in adults: full guideline (CG32).[ http://www.nice.org.uk/nicemedia/live/10978/29981/29981.pdf]
Pertschuk MJ, Forster J, Buzby G, Mullen JL: The treatment of anorexia nervosa with total parenteral nutrition. Biol Psychiatry 1981, 16: 539-550. PubMed
Lupoglazoff JM, Berkane N, Denjoy I, Maillard G, Leheuzey MF, Mouren-Simeoni MC, Casasoprana A: [Cardiac consequences of adolescent anorexia nervosa]. Arch Mal Coeur Vaiss 2001, 94: 494-498. PubMed
Kerem NC, Katzman DK: Brain structure and function in adolescents with anorexia nervosa. Adolesc Med 2003, 14: 109-118. PubMed
- Refeeding syndrome influences outcome of anorexia nervosa patients in intensive care unit: an observational study
AZUREA group (AnorexieRea Study Group)
- BioMed Central
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