Sɛ wudidi prɛko pɛ bere a wunni aduan a, dɛn na ɛba wo nipadua so? Momma yensua Refeeding Syndrome ho ade pɛpɛɛpɛ!

So woasusuw nea ɛto wo nipadua ho pɛn bere a wokɔ a wunnnidi nna pii na afei wofi ase didi bio mpofirim no? Ɛtɔ mmere bi a, sɛ wufi ase ma wo nipadua aduan mpofirim a, wubetumi ahyia ɔhaw ahorow a wonhwɛ kwan. Ɛno ne nea nnuruyɛfo frɛ no "refeeding syndrome." Ebia eyi bɛyɛ te sɛ nea ɛyɛ den, nanso momma yɛmma ɛnyɛ mmerɛw.

Dɛn ne saa ``Refeeding Syndrome'' yi?

Sɛ yɛbɛka no tiawa a, `(Refeeding Syndrome)` yɛ tebea a emu yɛ den a ebetumi aba bere a obi a onnya aduan pa fi ase didi bio no . Aduan pa a wonnya nni ne bere a wo nipadua no nnya aduannuru a ehia no. Enti, bere a wunni aduan bere tenten saa akyi no, sɛ wunya aduan mpofirim a, nsakrae akɛse bi ba nnuru a ɛwɔ yɛn nipadua mu no mu. Titiriw no, ɛkari pɛ kɛse betumi aba wɔ nkyene ahorow bi a ɛho hia (`(Electrolytes)`) dodow a ɛwɔ nipadua no mu no mu. Eyi betumi asɛe akwaa a ɛho hia te sɛ wo ntini, w’ahurututu, wo koma, ne w’amemene .

Hena na ɛda adi kɛse sɛ obenya ``Refeeding Syndrome''?

Eyi betumi ato obiara a wanya aduan pa nni na wafi ase redidi bio no. Sɛ wunnya aduan ne nsa nnɔɔso a, ebia aduan pa nni wo mu. Afei nso, aduan pa a wonnya nni betumi aba esiane nyarewa bi nti. Efisɛ, esiane nyarewa a ɛtete saa nti, ebia wuntumi nnidi anaasɛ wo nipadua no rentumi nnye aduan a wudi no yiye.

Nnipa a wɔwɔ asiane ahorow a edidi so yi taa nya ``Refeeding Syndrome``:

• Sɛ nnansa yi ara na wo nipadua mu duru so atew bɛboro 10% a. Sɛ nhwɛso no, sɛ wo mu duru yɛ kilogram 60 a, asiane wom sɛ wobɛtew bɛboro kilogram 6 prɛko pɛ.
• Sɛ wunni aduan bɛboro nnanson, na wowɔ adwene mu nhyɛso, na wo nipadua te nka sɛ ɛyɛ mmerɛw a.
• Wɔ nnipa a wɔwɔ adidi mu haw, te sɛ Anorexia Nervosa (adidi mu haw) anaa Bulimia Nervosa (adidi mu haw) fam no.
• Nnipa a wɔwɔ nyarewa a ɛmma nipadua no ntumi nnye aduan yiye , te sɛ dwensɔtwaa mu yare a enni sabea anaa dwensɔtwaa mu yare a ɛma ɛyɛ hyew.
• Wɔn a wɔanya aduannuru a wɔde fa anom bere tenten no fam no.
• Wɔ kokoram ayarefo ne wɔn a wɔreyɛ nnuru a wɔde sa yare no fam.
• Wɔn a wɔwɔ asikreyare a wontumi nni so (Diabetes Mellitus) fam.
• Wɔn a wɔnom nsa boro so bere tenten no fam.
• Wɔn a wɔanom nnuru a ekum asikre anaa nnuru a wɔde siw nsu mu bere tenten no fam.

Ɔkwan bɛn so na saa ``Refeeding Syndrome'' yi ba?

Sɛ wo nipadua no nnya aduannuru a ehia a, ɛyɛ nsakrae bi na ama ayɛ nsakrae. Wɔfrɛ ɔkwan a nipadua no fa so dan aduan ma ɛbɛyɛ ahoɔden no sɛ nipadua mu nneɛma a ɛsakra.Sɛ́ anka nipadua no benya carbohydrates a efi aduan mu no, efi ase hyew n’ankasa srade ne ntini ahorow de hwehwɛ ahoɔden. Eyi nso ma nipadua no mu nneɛma a ɛsakra no brɛ ase. Ahoɔden dodow a wosɛe bere a woregye w’ahome (`Resting Metabolic Rate`) betumi akɔ fam bɛyɛ 20%.

Saa nipadua mu nneɛma a ɛsakra yi mfa nneɛma kakraa bi na edi dwuma. Wɔmfa vitamin, mineral, ne ``electrolytes'' a yɛadi kan aka ho asɛm no nni dwuma wɔ saa adeyɛ yi mu, sɛnea ɛte wɔ nipadua mu nneɛma a ɛsakra a ɛfata mu no.

Nanso, sɛ wufi ase didi bio a, carbohydrates fi ase yɛ adwuma sɛnea ɛsɛ. Afei nipadua no hia saa `(Micronutrients)` no mpofirim na ama ayɛ saa adwuma yi. Ɛte sɛ nea adekoradan no mu nneɛma asa na mpofirim ara nneɛma pii a wɔkra ba Sɛ wo nipadua no nni saa aduannuru yi kakraa bi pɛ a wɔde asie a, ɛno na ɔhaw no fi ase.

Dɛn ne nea ɛde `(Refeeding Syndrome)` ba ankasa?

Ade titiriw nti a ɛte saa ne aduannuru nketenkete bi a enni wo nipadua mu. Eyinom sa bere a wunni aduan pa no. Aduannuru atitiriw a ɛka eyi ho ne Phosphorus, Potassium, ne Magnesium . Sɛ wufi ase didi bio a, mpofirim ara wo nkwammoaa hia saa electrolytes yi na ama aduan no ayɛ adwuma. Eyi ma nsakrae kɛse ba wo nipadua mu nnuru a ɛkari pɛ no mu, te sɛ ahodwiriw.

Saa `(Electrolytes)` a ɛwɔ wo mogya mu yi kɔ nkwammoaa no mu ntɛmntɛm yiye. Nanso, esiane sɛ wunni wɔn dodow a ɛdɔɔso wɔ wo nipadua mu nti, eyinom dodow a ɛwɔ wo mogya mu no so tew kɛse esiane nsakrae yi nti. Eyi ne `(Electrolyte)` dodow a ɛso tew wɔ wo mogya mu a wɔfrɛ no ``Deficiencies``. Ɛyɛ saa sintɔ ahorow yi nti na nipadua no mu nnuru a ɛkari pɛ no sɛe, na nsɛnnennen ahorow a wohu wɔ `(Refeeding Syndrome)` mu no ba.

Dɛn ne `(Refeeding Syndrome)` ho sɛnkyerɛnne?

Saa tebea yi betumi ada adi wɔ akwan horow so. Nea ɛtaa ba ne phosphate a enni nipadua no mu. Nanso, sintɔ afoforo ne nea ɛnkari pɛ nso betumi ama eyi aba.

Phosphate a enni nipadua mu (`(Hypophosphatemia)`) .

Phosphorus a enni nipadua no mu ne ``Refeeding Syndrome'' ho sɛnkyerɛnne a ɛtaa ba.`` Sɛ phosphate dodow sua a, ɛka nkwammoaa a ɛwɔ nipadua no mu nyinaa dwumadi. Eyi betumi de yare no ho sɛnkyerɛnne te sɛ:

• Ntini mu mmerɛwyɛ (te sɛ akwaa bi a ɛreyɛ mmerɛw) .
• Ɔhome a ɛyɛ den.
• Wofi ase hu nneɛma abien (`Double Vision`).
• Ɛyɛ den sɛ wobɛmene.
• Akisikuru a ɛma obi ho kyere no.
• Coma.
• Koma ntini a ɛyɛ mmerɛw (`(Cardiomyopathy)`).

Sɛ saa sɛnkyerɛnne ahorow yi mu yɛ den a , akwaa ahorow bi betumi agyae adwumayɛ na nkwa betumi asɛe . Enti, ɛnsɛ sɛ wobu eyi adewa.

Magnesium a enni nipadua mu (`(Hypomagnesemia)`) .

Magnesium nso ho hia ma yɛn nipadua no mu nneɛma a ɛsakra no. Sɛ magnesium sua a, ebetumi aka nipadua no akwaa biara. Nsɛnkyerɛnne te sɛ:

• Akisikuru ne ɔfe.
• Anorexia (`(Anomrexia)`).
• Wosow a ɛwosow.
• Ntini a ɛyɛ mmerɛw.
• Akisikuru a ɛma obi ho kyere no.
• Coma.
• Mogya a ɛkɔ koma no mu a ɛnkɔ yiye (Cardiac Ischemia).
• Koma mu nnyigyei a ɛnkɔ so pɛpɛɛpɛ (`(Arrhythmia)`).

Potassium a enni nipadua mu (`(Hypokalemia)`) .

Sɛ wowɔ potassium a ɛho nhia kakra a, ebia worenhu sɛnkyerɛnne titiriw biara. Nanso, sɛ sintɔ no mu yɛ den a, wubetumi anya nea edidi so yi:

• Ntini mu mmerɛwyɛ.
• Ntini mu akisikuru, ɛyaw.
• Ɔbrɛ a ɛboro so.
• Nsu a ɛkɔ nipadua no mu no gyae, na ɛma obi ho popo denneennen.
• Koma mu nnyigyei a ɛnkɔ so pɛpɛɛpɛ (`(Arrhythmia)`).
• Ɔhome a Ɛnyɛ Den.

Thiamine (Vitamin B1) a enni nipadua mu (`Thiamine a enni nipadua mu`) .

Saa thiamine a enni nipadua no mu yi da adi titiriw bere a wɔsan de aduan a carbohydrates pii wom ba no. Eyi betumi ama obi anya ntini mu yare a emu yɛ den:

• Delirium, adwene a ɛyɛ basaa.
• Anisoadehu mu haw ahorow.
• Nipadua mu hyew a ɛso tew (`(Hypothermia)`).
• Ɔhaw ahorow a ɛfa kari pɛ ne nkitahodi ho (`(Ataxia)`). "Ɛyɛ den sɛ wobɛnantew, te sɛ obi a wabow nsa."
• Nkae a ɛyera (`(Amnesia)`).
• Confabulation (nneɛma a ensii ho nkae).

Ɔhaw ahorow a ɛfa nsu a ɛkari pɛ wɔ nipadua no mu ho

Nsakrae a ɛba nipadua no mu nneɛma a ɛsakra mu no betumi aka nipadua no sodium ne nsu a ɛkari pɛ no. Sɛ wɔsan fi ase ma aduannuru a, eyi betumi ama ``Fluid Overload`` anaa ``Dehydration`` aba. Eyi betumi de tebea horow te sɛ:

• Mogya mmoroso a ɛba fam (hypotension).
• Ntini a ɛyɛ mmerɛw.
• Pulmonary Edema (nsu a ɛboaboa ano wɔ ahurututu mu).
• Asaabo dwumadi a asɛe.
• Koma a entumi nyɛ adwuma yiye (`(Congestive Cardiac Failure)`).
• Akisikuru a ɛma obi ho kyere no.

Mogya mu asikre dodow ho haw ahorow

Sɛ wɔsan ma aduan a, glucose a wɔsan de ba no betumi ama asikre a ɛwɔ mogya mu akɔ soro (hyperglycemia). Eyi te saa efisɛ:

• Tipaeɛ .
• Anisoadehu a ɛyɛ kusuu.
• Nsu a wɔtaa tow.
• Brɛ.

Ɔkwan bɛn so na wobehu `(Refeeding Syndrome)`?

Sɛ wufi ase didi bio a, w’aduruyɛfo kuw no bɛhwɛ wo sɛnkyerɛnne a ɛho hia no daa . Sɛ biribi a ɛnteɛ anaa sɛnkyerɛnne bi da adi a, wɔbɛyɛ ``Mogya Nhwehwɛmu`` de ahwehwɛ mu. Eyi bɛboa wɔn ma wɔahu nneɛma pɔtee a ɛnkari pɛ a wowɔ wɔ wo nipadua mu ne sɛnea emu yɛ den no ankasa.

Ɔkwan bɛn so na wɔsa ``Refeeding Syndrome''?

Ansa na wubefi ase adidi bio no, wo nnuruyɛfo bɛyɛ mogya mu nhwehwɛmu de ahwɛ sɛnea wo electrolyte dodow te na wɔahu sintɔ biara. Afei, wɔde saa aduannuru nketenkete a asɛe yi bɛka wo aduannuru a wode ma no ho. Adwene no ne sɛ wobedi kan ahyɛ aduannuru nketenkete a ayɛ mmerɛw yi ma. Afei, wo nipadua no besiesie ne ho yiye sɛ ɛbɛsakra carbohydrates.

Nanso kae sɛ, ɛtɔ da bi a, mogya mu nhwehwɛmu a edi kan no nnye saa `(Electrolyte)` sintɔ ahorow yi nyinaa. Esiane sɛ nipadua no nnya mfii ase redi aduan nti, ennim sɛ ebehia saa `(Electrolyte)`s yi daakye. Nsakraeɛ kɛseɛ a ɛbaa `(Electrolyte)` a ɛfiri mogya mu kɔ nkwammoaa no mu no nnya mmaeɛ. Esiane eyi nti, ɛtɔ mmere bi a sintɔ ahorow da adi bere a wɔafi ase ama aduan no akyi nkutoo.

W’aduruyɛfo kuw no bɛkɔ so ahwɛ wo so sɛ ebia wowɔ yare no ho sɛnkyerɛnne bi anaa. Wɔbɛhwɛ wo electrolyte dodow da biara da. Mpɛn pii no, refeeding syndrome no ba wɔ nnanu a edi kan wɔ bere a wɔsan ma wɔn aduan no mu. Sɛ sɛnkyerɛnne ahorow ba a, w’aduruyɛfo kuw no bɛbrɛ sɛnea worema aduan no ase. Wɔbɛtew carbohydrates dodow a ɛwɔ wo formula mu no so. Ebia wɔbɛma wo aduannuru a ɛyera no bi nso denam IV so.

Me ho bɛtɔ me ntɛm dɛn bere a wɔasa me yare awie no?

Sɛ oduruyɛfo hu sɛ ``Refeeding Syndrome'' pɛ a, wobetumi asiesie no ntɛm. Nanso, ebetumi agye adapɛn pii ansa na aduannuru nketenkete a na wonnya mfiase no asa. Eyi kyerɛ sɛ adeyɛ a wɔsan de ma no nyinaa gye bere kakra.

Ɔkwan bɛn so na wɔbɛtew asiane a ɛwɔ `(Refeeding Syndrome)` mu no so?

Ɛtɔ mmere bi a, wontumi nkwati hia a ehia sɛ wɔsan ma wɔn aduan bio. Nanso, yebetumi ayɛ ahwɛyiye bi:

• Sɛ wowɔ tebea bi a ɛtra hɔ kyɛ a ɛma wunya aduan pa a wonnya nni a, ɛho hia sɛ woma wɔsa no yiye . Ebia wo duruyɛfo bɛkamfo nnuru a wɔde ka aduan ho te sɛ vitamin ne mineral ahorow akyerɛ wo na aboa wo ma woanya aduannuru a wuhia.
• Sɛ woredi mmuada nna pii a, ɛbɛyɛ papa sɛ wobɛyɛ saa wɔ oduruyɛfo hwɛ ase.
• Mfa nsa, nnubɔne, anaa nnuru a wɔakyerɛw ama wo no nni dwuma ɔkwammɔne so. Sɛ wode eyinom mu biara di dwuma daa a, ɛbɛyɛ papa sɛ wobɛkɔ oduruyɛfo nkyɛn akɔhwɛ wo nyinaa na wɔayɛ wo mogya mu nhwehwɛmu.

So wubetumi anya nkwa wɔ `(Refeeding Syndrome)`?

Ɛwom sɛ ɛtɔ mmere bi a nsɛnnennen a efi ``Refeeding Syndrome'' mu ba no betumi adi awu de, nanso mpɛn pii no ɛnyɛ nea anibere wom saa . Sɛ nnuruyɛfo kuw no siesie nneɛma a ɛnkari pɛ no wie a, wobetumi asan yare no ho sɛnkyerɛnne pii, a ɛkyerɛ sɛ wobetumi asa.

``(Refeeding Syndrome)`` yɛ ɔhaw a ɛba bere a wɔresa aduan pa a wonnya nni. Aduan pa a wonnya nni nso yɛ tebea a ɛde adwennwen kɛse ba nipadua no so. Ebia ɛbɛyɛ te sɛ nea ɛyɛ nwonwa ma wo sɛ ayaresa pii a wɔde ma ntɛm dodo no betumi apira wo. Nanso,Aduan a wɔsan de ma no yɛ adeyɛ a ɛyɛ mmerɛw yiye na ɛyɛ den. Ɛyɛ papa sɛ wobɛyɛ eyi wɔ aduruyɛfo hwɛ ase. Sɛ woresan ama wo aduan wɔ nnuruyɛfo hwɛ ase a, wɔbɛhwɛ wo yiye. Wɔbɛbɔ mmɔden sɛ wɔbɛsiw `(Refeeding Syndrome)` ano, na sɛ ɛba a, wɔbɛsiesie wɔn ho sɛ wɔbɛdi ho dwuma.

Nneɛma a ɛho hia sen biara a ɛsɛ sɛ wokae (Take-Home Message) .

• Ɛsɛ sɛ wohwɛ yiye paa bere a woafi ase adidi bio bere a woanya aduan pa nni bere tiaa bi akyi no.
• Sɛnea wɔka sɛ, "Akwantuo a ɛyɛ brɛoo ne akwantuo a ɛyɛ papa" no, ɛsɛ sɛ wɔyɛ aduane nkakrankakra.
• Ɛyɛ nea asiane biara nni ho sɛ wɔbɛsan ama wɔn aduan wɔ aduruyɛfo hwɛ ase, titiriw ma wɔn a wɔwɔ akuw a asiane kɛse wom mu.
• Tie wo nipadua. Sɛ wote nka sɛ biribi yɛ soronko a, ntwentwɛn wo nan ase sɛ wobɛhwehwɛ aduruyɛ mu afotu.
• ``(Refeeding Syndrome)`` nyɛ biribi a ɛsɛ sɛ wosuro, nanso ɛho hia yiye sɛ wohu.

Enti, mewɔ anidaso sɛ saa nsɛm yi ho bɛba wo mfaso. Kɔ so nya apɔwmuden!

` Refeeding Syndrome, aduan pa a wonnya nni, electrolytes, aduan pa a wonnya nni, mmuadadi, sɛnkyerɛnne, ayaresa