{"id":9672,"date":"2025-04-07T07:58:15","date_gmt":"2025-04-07T07:58:15","guid":{"rendered":"https:\/\/www.btaytd.org\/web\/?p=9672"},"modified":"2025-04-07T07:58:25","modified_gmt":"2025-04-07T07:58:25","slug":"pusula-dergisi-mart-2025-sayisi-beslenme-bilimi","status":"publish","type":"post","link":"https:\/\/www.btaytd.org\/web\/tr\/pusula-dergisi-mart-2025-sayisi-beslenme-bilimi\/","title":{"rendered":"PUSULA DERG\u0130S\u0130 MART 2025 SAYISI – BESLENME B\u0130L\u0130M\u0130"},"content":{"rendered":"\n

REFEED\u0130NG SENDROMU<\/strong><\/p>\n\n\n\n

POTANS\u0130YEL \u00d6L\u00dcMC\u00dcL SENDROM<\/strong><\/p>\n\n\n\n

Refeeding (yeniden beslenme) sendromu uzun s\u00fcren a\u00e7l\u0131k veya yetersiz beslenmenin ard\u0131ndan h\u0131zl\u0131 ba\u015flayan “normal” beslenmeye ge\u00e7i\u015f sonucunda, elektrolit ve metabolik bozukluklar\u0131n e\u015flik etti\u011fi, hayat\u0131 tehdit eden, ciddi bir tablodur. Bu de\u011fi\u015fimler hormonal ya da metabolik bir\u00e7ok de\u011fi\u015fikli\u011fe yol a\u00e7arak ciddi komplikasyonlara yol a\u00e7ar. Yeniden beslenme sendromu potansiyel \u00f6l\u00fcmc\u00fcl bir sendrom olarak ifade edilir. Bu sendrom ba\u015flang\u0131\u00e7ta biyokimyasal bulgularla tespit edilebilir. Ay\u0131rt edici \u00f6zelli\u011fi ise hastan\u0131n kan\u0131ndaki fosfat de\u011ferlerinin d\u00fc\u015ferek hastada ”hipofosfatemi” geli\u015fmesidir.Tabloya \u00f6zellikle hipofosfatemi, hipokalemi ve hipomagnezemi gibi elektrolit bozukluklar\u0131n\u0131n yan\u0131 s\u0131ra B1 gibi vitamin d\u00fczeylerinde azalma, s\u0131v\u0131 dengesizli\u011fi ve tuz tutulumu da e\u015flik edebilir. Olu\u015fan dengesizlikler kardiyak, n\u00f6rolojik yan etkiler, bozulmu\u015f organ fonksiyonlar\u0131 hatta \u00f6l\u00fcme sebep olabilir. En \u00f6nemli \u00f6nleme veya koruma y\u00f6ntemi fark\u0131nda olmak, riskli hastalarda yeterli \u00f6nlemleri almakt\u0131r.<\/p>\n\n\n\n

Refeeding Sendromu Neden Olu\u015fur ?<\/p>\n\n\n\n

\u00b7 B\u00fcy\u00fck bir ameliyat nedeniyle metabolik olarak strese giren ve bir\u00e7ok ard\u0131\u015f\u0131k g\u00fcn boyunca \u00e7ok az d\u00fczeyde besin al\u0131m\u0131 alan bireyler refeeding sendromu riski alt\u0131ndad\u0131r. Beslenmeye ba\u015fland\u0131ktan sonraki d\u00f6rt g\u00fcn i\u00e7inde ortaya \u00e7\u0131karak s\u0131v\u0131 ve elektrolit dengesizli\u011fi sonucu hematolojik komplikasyonlar\u0131n geli\u015fmesine yol a\u00e7abilir. \u00b7 Oru\u00e7 s\u0131ras\u0131nda v\u00fccudun ana yak\u0131t kayna\u011f\u0131 de\u011fi\u015ferek karbonhidratlar yerine ya\u011f ve proteinler kullan\u0131l\u0131r.Uzun s\u00fcren a\u00e7l\u0131k durumu sonucu kas gibi protein kaynaklar\u0131ndan gelen amino asitler ana enerji kayna\u011f\u0131 olarak kullan\u0131l\u0131r. Temel enerji kayna\u011f\u0131n\u0131n de\u011fi\u015fmesi sonucu hormonel bozukluklar olu\u015fabilir.<\/p>\n\n\n\n

\u00b7 Anoreksiya nervoza gibi anorektik bireyler, kilo kayb\u0131 tak\u0131nt\u0131s\u0131 nedeniyle uzun s\u00fcreli yetersiz beslenebilir. Yetersiz kalori al\u0131m\u0131ndan sonra tekrar normal \u015fekilde yemeye ba\u015flan\u0131rsa, refeeding sendromunun ortaya \u00e7\u0131kma riski artabilir.<\/p>\n\n\n\n

\u00b7 Belirgin ve h\u0131zl\u0131 kilo kayb\u0131 olan obez hastalar, \u00f6zellikle h\u0131zl\u0131 kilo kay\u0131plar\u0131 i\u00e7in yap\u0131lan duodenal switch gibi mide operasyonlar\u0131 sonras\u0131 risk olduk\u00e7a y\u00fckselmektedir.<\/p>\n\n\n\n

\u00b7 \u0130rritabl ba\u011f\u0131rsak sendromu olan bireyler ve Kwashiorkor-Marasmus sendromlar\u0131 olan bebekler de risk alt\u0131ndad\u0131r.<\/p>\n\n\n\n

Refeeding Sendromu Belirtileri Nelerdir?<\/p>\n\n\n\n

Yeniden beslenme sendromuna ba\u011fl\u0131 olarak yaln\u0131zca ki\u015finin sindirim sistemi de\u011fil di\u011fer organ ve sistemleri de etkilenir. Enerji sentezinde sorunlar olu\u015fabilir.<\/p>\n\n\n\n

*Yorgunluk, *G\u00fc\u00e7s\u00fczl\u00fck, *Konf\u00fczyon (Patolojik derecede zihin bulan\u0131kl\u0131\u011f\u0131),*\u00a0Nefes almada g\u00fc\u00e7s\u00fczl\u00fck,<\/p>\n\n\n\n

*Y\u00fcksek kan bas\u0131nc\u0131,*\u00a0Kas\u0131lma n\u00f6betleri,*\u00a0Kalpte ritim bozukluklar\u0131 (aritmi) <\/p>\n\n\n\n

Refeeding Sendromu Tedavisi Nas\u0131ld\u0131r?<\/p>\n\n\n\n

-1. ve 3.g\u00fcn: Enerji takviyesi 10 kcal\/kg\/g\u00fcn ile ba\u015flanmal\u0131 ve yava\u015f\u00e7a 15 kcal\/kg\/g\u00fcne artt\u0131r\u0131lmal\u0131d\u0131r. Bu s\u00fcre\u00e7te karbonhidrat oran\u0131 %50-60, ya\u011f oran\u0131 %30-40, protein oran\u0131 %15-20 olmal\u0131d\u0131r. Refeeding sendromu elektrolit replasman\u0131 i\u00e7in bazal de\u011fer \u00f6l\u00e7\u00fclerek 4-6 saatte bir tekrarlanmal\u0131d\u0131r. Ard\u0131ndan g\u00fcnde 1 kez olacak \u015fekilde takip yap\u0131lmal\u0131d\u0131r.<\/p>\n\n\n\n

– 4.ve 6. g\u00fcnde: Enerji takviyesi 10-20 kcal\/kg\/g\u00fcn ile artt\u0131r\u0131larak devam edilir. Bu s\u00fcre\u00e7te karbonhidrat oran\u0131 %50-60, ya\u011f oran\u0131 %30-40, protein oran\u0131 %15-20 olmal\u0131d\u0131r.<\/p>\n\n\n\n

– 7.ve 10.g\u00fcnde: Enerji takviyesi 20-30 kcal\/kg\/g\u00fcn ile devam edilmelidir. Bu s\u00fcre\u00e7te karbonhidrat oran\u0131 %50-60, ya\u011f oran\u0131 %30-40, protein oran\u0131 %15-20 olmal\u0131d\u0131r. Demir deste\u011fi 7.g\u00fcnden itibaren ba\u015flanmal\u0131d\u0131r.<\/p>\n\n\n\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 DO\u011eA KASAP<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

REFEED\u0130NG SENDROMU POTANS\u0130YEL \u00d6L\u00dcMC\u00dcL SENDROM Refeeding (yeniden beslenme) sendromu uzun s\u00fcren a\u00e7l\u0131k veya yetersiz beslenmenin ard\u0131ndan h\u0131zl\u0131 ba\u015flayan “normal” beslenmeye ge\u00e7i\u015f sonucunda, elektrolit ve metabolik bozukluklar\u0131n e\u015flik etti\u011fi, hayat\u0131 tehdit eden, ciddi bir tablodur. Bu de\u011fi\u015fimler hormonal ya da metabolik bir\u00e7ok de\u011fi\u015fikli\u011fe yol a\u00e7arak ciddi komplikasyonlara yol a\u00e7ar. Yeniden beslenme sendromu potansiyel \u00f6l\u00fcmc\u00fcl bir sendrom<\/p>\n

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