RT Journal Article SR Electronic T1 Overfeeding and overhydration in elderly medical patients: lessons from the Liverpool Care Pathway JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP 248 OP 251 DO 10.7861/clinmedicine.13-3-248 VO 13 IS 3 A1 Eleni Tsiompanou A1 Caroline Lucas A1 Mike Stroud YR 2013 UL http://www.rcpjournals.org/content/13/3/248.abstract AB This paper describes three elderly patients who were admitted to hospital with aspiration pneumonia. They were kept nil by mouth (NBM) for a number of days, while being given intravenous hydration initially and enteral feeding subsequently. During that time they deteriorated and appeared to be dying, so the Liverpool Care Pathway (LCP) for the dying was used to support their care. Artificial nutrition and hydration were stopped. They quickly improved and the LCP was discontinued. Two of the patients deteriorated again on reintroduction of enteral feeding and/or intravenous fluids, only to improve a second time following withdrawal of feeding and fluids. Vulnerable elderly patients should not be made NBM except as a last resort. Clinicians should be alert to the possibility of refeeding syndrome and overhydration as reversible causes of clinical deterioration, particularly in frail elderly patients. Use of the LCP in these patients provided a unique opportunity to witness the positive effects of withdrawal of excessive artificial nutrition and hydration.