The three hospitals responsible for the reception of the expected 20 live hostages have been prepared to treat them in conditions of severe malnutrition, the Health Ministry announced on Sunday.
According to estimates by health system officials, most of the abductees now returning to Israel suffered from severe malnutrition, severe salt and vitamin deficiencies, and are at risk of developing "refeeding syndrome."
That is why personnel at Sheba Medical Center, Rabin Medical Center-Beilinson Campus, and Sourasky Medical Center's Ichilov Hospital have been instructed to implement a gradual and especially careful treatment. The kidnapped are expected to undergo a series of comprehensive tests upon their arrival to assess their exact condition before starting the feeding.
What will be the treatment for released hostages?
The first stage of treatment will focus on correcting critical deficiencies in minerals and salts. Doctors and dietitians will start by giving small amounts of liquid food rich in proteins, but low in carbohydrates, to avoid a sharp increase in insulin levels.
Phosphorus, potassium, and magnesium supplements will then be given intravenously or orally, while continuously monitoring their levels in the blood and other vital indicators such as pulse, blood pressure, sugar levels, and heart and kidney function.
The treatment will progress at a measured pace, sometimes over days, depending on the condition of each victim. Only after the electrolyte balance stabilizes will the menu be gradually expanded to solid foods.
The hospitals emphasized that at each stage, close supervision by a doctor, dietitian, and social worker will be maintained. In addition to the physical effects, returning to normal eating may also overwhelm emotional reactions and traumas from captivity.
What is “refeeding syndrome”?
“Refeeding syndrome” is a metabolic condition that could cause disorders in the heart, brain, and other vital systems in the body, and even lead to death if not identified and treated properly.
During prolonged starvation, the body goes into survival mode. Blood sugar levels drop, insulin secretion decreases, and the body begins to break down fat and protein stores to produce energy.
This process is accompanied by a slowdown in the metabolic rate, a decrease in muscle mass and consumption of energy, and a decrease in the levels of phosphorus, potassium, and magnesium in the blood. In this state, every system in the body, from the heart to the brain, operates in emergency mode in order to maintain only basic functions.
The problem arises precisely at the moment when the starvation ends. The introduction of food into the body, especially food rich in carbohydrates, causes a sharp increase in sugar levels and renewed secretion of insulin.
Insulin pushes sugar and important salts, primarily phosphorus, magnesium, and potassium, into the cells, and as a result, their levels in the blood drop rapidly. These sudden changes may lead to a dangerous chain of reactions: cardiac arrhythmias, severe muscle weakness, confusion, edema, kidney failure, and even respiratory failure.
In severe cases of refeeding syndrome, multisystem collapse may occur within a few hours of the start of feeding. Therefore, all hospitals have updated the guidelines for gradual and especially careful treatment.
According to medical sources, the first sign that can alert you to the syndrome is a sharp drop in phosphorus levels. In such situations, feeding should be stopped immediately, the salt balance should be restored, and only continued gradually. The syndrome is not unique to captivity, but is well known among survivors of starvation, anorexic patients, or patients in severe malnutrition.