Protein malnutrition after Roux-en-Y gastric bypass: a challenging case and scoping review of the literature

Mantziari, Styliani; Abboretti, Francesco; Favre, Lucie; Thomopoulos, Théodoros; Barigou, Mohammed; Demartines, Nicolas; Suter, Michel

doi:10.1016/j.soard.2022.12.032

Cited by 7 publications

(1 citation statement)

References 49 publications

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“…A recent scoping review, including 18 studies with 3,015 patients who underwent RYGB, indicated that hypoalbuminemia, although rare after RYGB, occurs in 1.7% (range 0-8.9%), usually diagnosed after 12-120 months after the operation. This condition is mostly related to decreased intake of protein, but triggering factors such as vomiting and dysphagia, as well as a small alimentary limb (<250-300 cm) are also associated risk factors [11]. In obese patients with cardiac failure, the excess weight was directly correlated with cardiogenic shock and length of hospital stay, as well as, with increased hospital costs [12].…”

Section: Key Pointsmentioning

confidence: 99%

Nutritional management during critical illness in those with previous obesity surgery

Correia,

Rosenfeld

2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review The prevalence of overweight and obesity in our society is a pressing concern that has demanded immediate attention. Traditional treatments have proven ineffective for many individuals, leading to a surge in bariatric surgery as a last resort. While the rate of early and late postoperative complications may be low, when they occur, they place these patients at higher risk of requiring intensive care treatment. Therefore, it is our aim to discuss the nutritional care of these individuals. Recent findings Nutritional management of critically ill postbariatric surgical patients is related to the difficulty of providing an adequate nutritional assessment, calculating the macro and micronutrient requirements, choosing the right therapy, and defining the timely moment to initiate it. The anatomic changes related to the bariatric operation pose a high risk for a nonfunctional gastrointestinal tract both in the early postoperative and late postoperative. Therefore, the route of nutrition will greatly rely on the absorptive capacity, as well as on the nutritional status, with parenteral nutrition being an early option, especially for those with high critical care severity scores. Also, these patients are known to have an altered microbiota which may influence the absorptive capacity. Immunonutrition, prebiotics, probiotics, and symbiotics may represent potential options, but there is currently little support for ‘one size fits all’. Summary The nutritional care of critically ill patients postbariatric surgery is a complex and nuanced process requiring a multifaceted precision approach. The distinct nutritional challenges of early and late postoperative patients necessitate a thorough nutritional assessment and a highly individualized nutritional care plan.

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Section: Key Pointsmentioning

confidence: 99%