FAQs: Rapid Fire Answers to Pesky Clinical Questions - NGTs? Thiamine? PO Contrast? Nonsurgical Complications?
Bariatric patients encounter unique challenges. Blind placement of NG or OG tubes can be a risky procedure in those patients with altered anatomy. Clinicians should not place an NG tube blindly in those patients within 30 days of their surgery and consider fluoroscopic guidance when possible. Fluid intake, including oral contrast, should be limited to 6 oz (177 mL) for patients with stomach-altering bariatric surgeries, such as Roux-en-Y gastric bypass and sleeve gastrectomy, to accommodate the small gastric pouch. Nutritional deficiencies are common, and thiamine deficiency can lead to Wernicke’s encephalopathy in bariatric surgery patients. Venous thromboembolism and anastomotic leaks are both associated with significant morbidity and mortality in this population.