Nukae dzɔna ɖe wò ŋutilã dzi ne èɖu nu zi ɖeka le nuɖuɖu manɔmee vɔ megbe? Mina míasrɔ̃ nu tso Refeeding Syndrome ŋu pɛpɛpɛ!

Èbu nusi dzɔna ɖe wò ŋutilã dzi ne mèɖu nu ŋkeke geɖe o eye kasia nègadze nuɖuɖu gɔmea? Ɣeaɖewoɣi ne èdze nuɖuɖu nana wò ŋutilã gɔme zi ɖeka la, kuxi siwo mèle mɔ kpɔm na o ate ŋu ado mo ɖa. Emae nye nusi ɖɔktawo yɔna be "refeeding syndrome." Esia aɖi nya sesẽ, gake mina míana wòanɔ bɔbɔe.

Nukae nye ``Gbugbɔganyi ƒe Dɔléle'' sia?

Kpuie ko la, `(Refeeding Syndrome)` nye nɔnɔme sesẽ aɖe si ate ŋu adzɔ ne ame aɖe si mekpɔa nu nyui ɖuna o la gadze nuɖuɖu gɔme ake . Nunyuimakpɔɖui nye ne wò ŋutilã mekpɔ nunyiame siwo wòhiã o. Eyata le nuɖuɖu manɔmee ɣeyiɣi didi ma megbe la, ne èkpɔ nuɖuɖu kasia la, tɔtrɔ gã aɖewo vaa atikewo ƒe dɔwɔwɔ le míaƒe ŋutilã me. Vevietɔ la, masɔmasɔ gãwo ate ŋu anɔ dze vevi aɖewo (`(Electrolytes)`) ƒe agbɔsɔsɔ me le ŋutilãa me. Esia ate ŋu agblẽ nu le ŋutinu veviwo abe wò lãmekawo, lãkusiwo, dzi, kple ahɔhɔ̃ ene ŋu .

Amekae ate ŋu axɔ ``Refeeding Syndrome'' wu?

Esia ate ŋu adzɔ ɖe amesiame si nunyuimakpɔɖui eye wògadze nuɖuɖu gɔme ake dzi. Ne mèle nuɖuɖu kple nunono ɖum o la, ke ate ŋu anye be nunyuimakpɔɖu le ŋuwò. Azɔ hã, nunyuimakpɔɖu ate ŋu ado mo ɖa le dɔléle aɖewo ta. Elabena, le dɔléle mawo ta la, ɖewohĩ màte ŋu aɖu nu o alo wò ŋutilã mate ŋu axɔ nuɖuɖu si nèɖuna nyuie o.

Ame siwo ŋu afɔku siwo gbɔna le la ate ŋu axɔ ``Refeeding Syndrome``:

• Ne èɖe wò kpekpeme ƒe 10% kple edzivɔ dzi kpɔtɔ nyitsɔ laa. Le kpɔɖeŋu me, ne wò kpekpeme nye kilogram 60 la, afɔku le eme be nàɖe kilogram 6 kple edzivɔ zi ɖeka.
• Ne nuɖuɖu mele ŋuwò o wu ŋkeke adre, susu me nuteɖeamedzi le ŋuwò, eye wò ŋutilã se le eɖokui me be yegbɔdzɔ.
• Le amesiwo ŋu nuɖuɖukuxiwo le, abe Anorexia Nervosa (nuɖuɖukuxi) alo Bulimia Nervosa (nuɖuɖukuxi) ene gome.
• Ame siwo ŋu dɔléle siwo xea mɔ na ŋutilãa mete ŋu xɔa nuɖuɖu nyuie o , abe dɔgbo ƒe dɔléle si nɔa anyi didi alo dɔgbo ƒe dɔléle si naa dɔdzẽ ene.
• Le amesiwo le nunyiame si wotsɔa nu me xɔm ɣeyiɣi didi aɖee nye sia gome.
• Na kansadɔnɔwo kple amesiwo wole atikewɔmɔnu zãm.
• Le amesiwo ŋu suklidɔ si dzi womate ŋu aɖu o (Diabetes Mellitus) le gome.
• Le amesiwo noa aha fũu akpa ɣeyiɣi didi gome.
• Le amesiwo noa antacids alo diuretics ɣeyiɣi didi aɖee nye sia gome.

Aleke ``Gbugbɔganyi ƒe Dɔléle'' sia dzɔna?

Ne wò ŋutilã mekpɔ nunyiame siwo wòhiã o la, ewɔa tɔtrɔ aɖewo be wòatrɔ ɖe nɔnɔmeawo ŋu. Woyɔa nusi ŋutilã tona trɔa nuɖuɖu wòzua ŋusẽ be lãmenugbagbeviwo ƒe dɔwɔwɔ.Le esi teƒe be ŋutilãa nakpɔ carbohydrates siwo tso nuɖuɖu me la, edzea eya ŋutɔ ƒe ami kple lãmekawo fifi gɔme hena ŋusẽkpɔkpɔ. Esia hã nana be lãmenugbagbeviwo ƒe dɔwɔwɔ dzi ɖena kpɔtɔna. Ŋusẽ si nèzãna esime nèle ɖiɖim ɖe eme (`Resting Metabolic Rate`) ateŋu aɖiɖi abe 20% ene.

Lãmetsiŋusẽ ƒe dɔwɔwɔ sia ƒomevi zãa nunɔamesi ʋɛ aɖewo ko. Womezãa vitamin, mineral, kple ``electrolytes'' siwo míeyɔ va yi le ɖoɖo sia me o, abe alesi wòle le lãmenugbagbeviwo ƒe dɔwɔwɔ nyuie me ene.

Gake, ne ègadze nuɖuɖu gɔme ake la, carbohydrates dzea lãmenugbagbeviwo ƒe dɔwɔwɔ gɔme le mɔ nyuitɔ nu. Emegbe kasia ŋutilãa hiã `(Micronutrients)` mawo be wòawɔ dɔ sia. Ðeko wòle abe ɖe nudzraɖoƒea vɔ eye kasia nudɔdɔ gã aɖe va ene. Ne nunyiame siawo ʋɛ aɖewo koe le wò ŋutilã me si wodzra ɖo la, ɣemaɣie kuxia dzea egɔme.

Nuka tututue nye nusi gbɔ `(Refeeding Syndrome)` tsona?

Nusi koŋ gbɔ esia tsoe nye nunyiame suesuesue aɖewo ƒe anyimanɔmanɔ le wò ŋutilã me. Esiawo vɔna ne nunyuimakpɔɖui le ŋuwò. Nunyiame vevi siwo le esia me enye Phosphorus, Potassium, kple Magnesium . Ne ègadze nuɖuɖu gɔme ake la, kasia wò lãmenugbagbeviwo hiã elektrikŋusẽ siawo be woatrɔ asi le nuɖuɖua ŋu. Esia hea tɔtrɔ gã aɖe vaa wò ŋutilã ƒe atikewo ƒe dadasɔ me, abe alesi wòwɔa nuku ene.

Wotsɔa `(Electrolytes)` siawo siwo le wò ʋu me yia lãmenugbagbeviwo me kabakaba ŋutɔ. Gake esi womesɔ gbɔ na wò le wò ŋutilã me o ta la, esiawo ƒe agbɔsɔsɔ le wò ʋu me dzi ɖena kpɔtɔna ŋutɔ le tɔtrɔ sia ta. Esia nye `(Electrolyte)` ƒe agbɔsɔsɔ dzi ɖeɖe kpɔtɔ le wò ʋu me si woyɔna be ``Deficiencies``. Nusiawo ƒe gbɔdzɔgbɔdzɔ tae ŋutilãa ƒe atikewo ƒe dadasɔ me gblẽna, eye kuxi vovovo siwo wokpɔna le `(Refeeding Syndrome)` me la dzɔna.

Nukae nye `(Refeeding Syndrome)` ƒe dzesiwo?

Nɔnɔme sia ate ŋu adze le mɔ vovovowo nu. Nusi bɔ wue nye phosphate ƒe anyimanɔmanɔ. Gake gbɔdzɔgbɔdzɔ bubuwo kple dadasɔmakpɔmakpɔ hã ate ŋu ana esia nadzɔ.

Phosphate ƒe anyimanɔmanɔ (`(Hypophosphatemia)`) .

Phosphorus ƒe anyimanɔmanɔ nye dzesi si bɔ wu le ``Refeeding Syndrome.`` Ne phosphate ƒe agbɔsɔsɔ le sue la, ekpɔa ŋusẽ ɖe lãmenugbagbeviwo ƒe dɔwɔwɔ dzi le ŋutilã bliboa me. Esia ate ŋu ahe dzesiwo abe:

• Lãmetsiwo ƒe gbɔdzɔgbɔdzɔ (abe abɔ kple afɔ si le ʋuʋum ene) .
• Yagbɔgbɔ sesẽ.
• Dzedze nuwo kpɔkpɔ le eve me (`Double Vision`).
• Nu mimi sesẽ.
• Alɔ̃madɔmadɔ.
• Coma.
• Dzi ƒe lãmeka ƒe gbɔdzɔgbɔdzɔ (`(Cardiomyopathy)`).

Ne dzesi siawo nu sẽ la , ŋutinu aɖewo ate ŋu adzudzɔ dɔwɔwɔ eye agbe ate ŋu agblẽ . Eyata mele be woabu esia nu tsɛe o.

Magnesium ƒe anyimanɔmanɔ (`(Hypomagnesemia)`) .

Magnesium hã le vevie na míaƒe ŋutilã ƒe lãmenugbagbeviwo ƒe dɔwɔwɔ. Ne magnesium mesɔ gbɔ o la, ate ŋu agblẽ nu le ŋutilãa ƒe ŋutinu ɖesiaɖe ŋu. Dzesiwo abe:

• Aɖuɖɔtoe kple ʋuʋudedi.
• Nuɖuɖumadzroame (`(Nuɖuɖumadzroame)`).
• Ʋuʋudedi.
• Lãmetsiwo ƒe ʋuʋu.
• Alɔ̃madɔmadɔ.
• Coma.
• Ʋu ƒe sisi yi dzia me ƒe gbegblẽ (Cardiac Ischemia).
• Dzi ƒe tsotso ƒe masɔmasɔ (`(Arrhythmia)`).

Potassium ƒe anyimanɔmanɔ (`(Hypokalemia)`) .

Ne potassium ƒe veve vie le ŋuwò la, ɖewohĩ màkpɔ dzesi gã aɖeke o. Gake ne gbɔdzɔgbɔdzɔa nu sẽ la, àte ŋu akpɔ nu siwo gbɔna:

• Lãmetsiwo ƒe gbɔdzɔgbɔdzɔ.
• Lãmetsiwo ƒe ʋuʋu, vevesese.
• Ðeɖiteameŋu si gbɔ eme.
• Aɖuɖɔtoewo nu tsona, si wɔnɛ be dɔgbo sesẽ.
• Dzi ƒe tsotso ƒe masɔmasɔ (`(Arrhythmia)`).
• Yagbɔgbɔ ƒe Dɔmawɔmawɔ nyuie.

Thiamine (Vitamin B1) ƒe anyimanɔmanɔ (`Thiamine ƒe anyimanɔmanɔ`) .

Thiamine ƒe anyimanɔmanɔ sia dzena vevietɔ ne wogbugbɔ nuɖuɖu si me carbohydrates sɔ gbɔ ɖo vɛ. Esia ate ŋu ahe ahɔhɔ̃mekawo ƒe dzesi sesẽwo vɛ:

• Delirium, tɔtɔ.
• Nukpɔkpɔ ƒe kuxiwo.
• Ŋutilã ƒe dzoxɔxɔ dzi ɖe kpɔtɔ (`(Hypothermia)`).
• Kuxi siwo le dadasɔ kple nuwɔwɔ aduadu me (`(Ataxia)`). "Azɔlizɔzɔ sesẽ, abe amesi mu aha ene."
• Ŋkuɖodzi ƒe bu (`(Amnesia)`).
• Confabulation (nu siwo medzɔ o dzi kpɔkpɔ).

Kuxi siwo le tsi ƒe dadasɔ le ŋutilã me ŋu

Tɔtrɔ siwo va le lãmenugbagbeviwo ƒe dɔwɔwɔ me ate ŋu akpɔ ŋusẽ ɖe ŋutilãa ƒe sodium kple tsi ƒe dadasɔ dzi. Ne wogadze nunyiame gɔme ake la, esia ateŋu ahe ``Lãmetsi ƒe Agbanɔamedzi`` alo ``Tsikuɖiɖi`` vɛ. Esia ate ŋu ahe nɔnɔmewo abe:

• Ʋu ƒe sisi ƒe ɖiɖi (ʋusɔgbɔdɔ).
• Lãmetsiwo ƒe ʋuʋu.
• Pulmonary Edema (tsi ƒe ƒuƒoƒo ɖe aklã me).
• Ayikuwo ƒe dɔwɔwɔ ƒe gbegblẽ.
• Dzi ƒe dɔmawɔmawɔ nyuie (`(Congestive Cardiac Failure)`).
• Alɔ̃madɔmadɔ.

Sukli ƒe agbɔsɔsɔ le ʋu me ƒe kuxiwo

Ne wogbugbɔ le nuɖuɖu nam la, sukli ƒe gbugbɔgage ate ŋu ana sukli nasɔ gbɔ ɖe ʋu me (suklidɔ ƒe agbɔsɔsɔ fũ). Esia le alea elabena:

• Taɖuame .
• Nukpɔkpɔ si me mekɔ o.
• Aɖuɖɔɖɔɖɔ enuenu.
• Ɖeɖi te eŋu.

Aleke woawɔ ade dzesi `(Refeeding Syndrome)`?

Ne ènya dze nuɖuɖu gɔme ake ko la, wò atikewɔlawo ƒe ƒuƒoƒoa alé ŋku ɖe wò dzesi veviwo ŋu edziedzi . Ne nusiwo mesɔ o alo dzesi aɖewo dze la, woawɔ ``Ʋudodokpɔ`` atsɔ aku nu me. Esia akpe ɖe wo ŋu woade dzesi masɔmasɔ siwo koŋ le wò ŋutilã me kple alesi gbegbe wosẽe.

Aleke wokpɔa ``Refeeding Syndrome'' gbɔe?

Hafi nàgadze nuɖuɖu gɔme ake la, wò ɖɔktawo awɔ ʋudodokpɔ aɖe atsɔ akpɔ wò elektrikŋusẽ ƒe agbɔsɔsɔ ahade dzesi nusiwo mehiã o. Emegbe, woatsɔ nunyiame sue siawo siwo vɔ le eme akpe ɖe wò nunyiame ƒe mɔli ŋu. Susuae nye be woagbugbɔ nunyiame sue siawo siwo vɔ le la ade eme gbã. Ekema, wò ŋutilã adzra ɖo nyuie wu be wòatrɔ asi le carbohydrates ŋu.

Gake ɖo ŋku edzi be, ɣeaɖewoɣi la, ʋudodokpɔ gbãtɔ mefɔa `(Electrolyte)` ƒe gbɔdzɔgbɔdzɔ siawo katã o. Esi ŋutilãa medze nuɖuɖu gɔme haɖe o ta la, menya be yeahiã `(Electrolyte)` siawo le etsɔme o. Tɔtrɔ gã si va le `(Electrolyte)` ƒe ʋuʋu tso ʋu me yi lãmenugbagbeviwo me la medzɔ haɖe o. Le esia ta la, ɣeaɖewoɣi ne wodze nuɖuɖu nana gɔme ko hafi nusiwo mehiã o dona.

Wò atikewɔlawo ƒe ƒuƒoƒoa ayi edzi anɔ ŋku lém ɖe ŋuwò be dɔlélea ƒe dzesiwo le ŋuwò hã. Woalé ŋku ɖe wò elektrikŋusẽ ƒe agbɔsɔsɔ ŋu gbesiagbe. Zi geɖe la, nuɖuɖu gbugbɔganyi ƒe dɔlélea dzɔna le ŋkeke atɔ̃ gbãtɔ siwo me wogatsɔ nuɖuɖu na wo ake me. Ne dzesiwo dze la, wò atikewɔlawo ƒe ƒuƒoƒoa aɖe alesi nèle nuɖuɖu nam wòe dzi akpɔtɔ. Woaɖe carbohydrates ƒe agbɔsɔsɔ si le wò notsi me dzi akpɔtɔ. Woate ŋu ana nunyiame siwo bu na wò la dometɔ aɖewo hã wò to IV-dɔdamɔnu dzi.

Aleke gbegbee nye lãme ahaya kaba le atikewɔwɔ vɔ megbe?

Ne ɖɔkta nya kpɔ ``Refeeding Syndrome'' ko la, woateŋu aɖɔe ɖo kaba. Gake ate ŋu axɔ kwasiɖa geɖe hafi nunyiame suesuesue siwo mehiã o le gɔmedzedzea me nahaya. Esia fia be nuɖuɖu nana bliboe xɔa ɣeyiɣi aɖe.

Aleke woawɔ aɖe afɔku si le `(Refeeding Syndrome)` me dzi akpɔtɔ?

Ɣeaɖewoɣi la, womate ŋu aƒo asa na alesi wòhiã be woagbugbɔ nuɖuɖu ana wo o. Ke hã, míate ŋu awɔ afɔɖeɖe aɖewo:

• Ne dɔléle aɖe si nɔa ŋuwò ɣeyiɣi didi si hea nunyuimakpɔɖu vɛ la, ele vevie be nàna woakpɔ egbɔ nyuie . Wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàzã kpeɖeŋutɔ, abe vitamin kple mineral ene, be wòakpe ɖe ŋuwò nàkpɔ nunyiame siwo nèhiã.
• Ne èle nu tsim ŋkeke geɖe la, anyo wu be nàwɔe le ɖɔkta ƒe dzikpɔkpɔ te.
• Mègazã aha sesẽ, atike vɔ̃ɖiwo, alo atike siwo woŋlɔ na wò le mɔ gbegblẽ nu o. Ne èzãa nusiawo dometɔ aɖe edziedzi la, anyo be nàyi ɖɔkta gbɔ be woado wò kpɔ le afisiafi ahado ʋu kpɔ.

Àte ŋu atsi agbe le `(Refeeding Syndrome)` mea?

Togbɔ be kuxi siwo tso ``Refeeding Syndrome'' me ateŋu awu ame ɣeaɖewoɣi hã la, zi geɖe la, womesẽna nenema gbegbe o . Ne atikewɔlawo ƒe ƒuƒoƒoa nya ɖɔ masɔmasɔawo ɖo ko la, woate ŋu atrɔ dzesi geɖe, si fia be woate ŋu ada wo.

``(Refeeding Syndrome)`` nye kuxi si dzɔna le nunyuimakpɔɖui dada me. Nunyuimakpɔɖu hã nye nɔnɔme si dea nuteɖeamedzi geɖe ŋutilã me. Ate ŋu awɔ nuku na wò be atikewɔwɔ fũu akpa nana kaba akpa ate ŋu agblẽ nu le ame ŋu. Gake,Nuɖuɖu gbugbɔgana nye nusi me kɔ ŋutɔ eye wòsesẽ ŋutɔ. Anyo wu be nàwɔ esia le atikewɔlawo ƒe dzikpɔkpɔ te. Ne èle nu nam ake le ɖɔktawo ƒe dzikpɔkpɔ te la, woalé ŋku ɖe ŋuwò nyuie. Woadze agbagba be yewoaxe mɔ na `(Refeeding Syndrome)` be wòagadzɔ o, eye woanɔ klalo be yewoakpɔ egbɔ ne edzɔ.

Nu vevitɔ kekeake siwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

• Ele be nàɖɔ ŋu ɖo ŋutɔ ne ègadze nuɖuɖu gɔme ake le nunyuimakpɔɖui ƒe ɣeyiɣi aɖe megbe.
• Abe alesi wogblɔna be, "Mɔzɔzɔ blewu ye nye mɔzɔzɔ nyuitɔ" ene la, ele be woana nuɖuɖu vivivi vivivi.
• Ele dedie wu be woagatsɔ nuɖuɖu ana le atikewɔlawo ƒe dzikpɔkpɔ te, vevietɔ na amesiwo le afɔku ƒe hatsotsowo me.
• Ðo to wò ŋutilã. Ne èse nane si mebɔ o la, mègahe ɖe megbe le atikewɔlawo ƒe aɖaŋuɖoɖo didi me o.
• ``(Refeeding Syndrome)`` menye nusi wòle be woavɔ̃ na o, gake ele vevie ŋutɔ be nànyae.

Eyata, mele mɔ kpɔm be nyatakaka sia aɖe vi na wò. Nɔ lãmesẽ me!

` Refeeding Syndrome, nunyuimakpɔɖu, electrolytes, nunyiame, nutsitsidɔ, dzesiwo, atikewɔwɔ