title: Use of Home Parenteral Nutrition in Post-Bariatric Surgery-Related Malnutrition.
abstract: Bariatric surgery is one of the most effective techniques for achieving sustained weight loss but can be associated with surgical complications or malabsorption so significant that it leads to malnutrition. Parenteral nutrition (PN) may be necessary to help treat surgical complications or malnutrition from these procedures. There are limited data describing this patient population and role for home PN (HPN).
  
  
  
  A retrospective review of our HPN database was conducted to identify patients who were initiated on HPN between January 1, 2003, and August 31, 2015, and had a history of bariatric surgery.
  
  
  
  A total of 54 HPN patients (6.3%) had a history of bariatric surgery. Average age was 52.1 ± 12.8 years, and 80% were female. The most common surgical procedure was Roux-en-Y gastric bypass (72%), with malnutrition or failure to thrive being the most common HPN indication (57%). Weight at the time of HPN initiation was 71.9 ± 20.4 kg and significantly increased to 78.9 ± 24.4 kg by the end of treatment ( P = .0001). Serum albumin levels rose from 2.8 ± 0.77 g/dL to 3.7 ± 0.58 g/dL by the end of HPN ( P < .0001). Forty-five of 54 patients (83.3%) went on to revision surgery.
  
  
  
  The results of this retrospective review support initiation of HPN in the malnourished post-bariatric surgery patient both nutritionally and as a bridge to revision surgery.
authors.affiliation: 1 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Manpreet S
authors.initials: MS
authors.lastname: Mundi
authors.affiliation: 1 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Nishanth
authors.initials: N
authors.lastname: Vallumsetla
authors.affiliation: 2 Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Jacob B
authors.initials: JB
authors.lastname: Davidson
authors.affiliation: 2 Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Megan T
authors.initials: MT
authors.lastname: McMahon
authors.affiliation: 2 Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Bonnes
authors.affiliation: 1 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.|2 Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.|3 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.|4 Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, Kentucky, USA.
authors.forename: Ryan T
authors.initials: RT
authors.lastname: Hurt
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects*; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D016331:Parenteral Nutrition, Home / Q000009:adverse effects*; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D015430:Weight Gain; D015431:Weight Loss
chemical_list: D012709:Serum Albumin
keywords: bariatric surgery; home nutrition support; nutrition; parenteral nutrition; research and diseases