Prolonged malnourished states can predispose patients to refeeding syndrome with the uncommon complication of cardiogenic shock if not corrected initially. While refeeding syndrome is well studied its complications may not be easily identified in the setting of rapid deterioration. This case report reviews the events of a 57-year-old male who was brought in by law enforcement, for altered mental status and agitation, after being found wandering in the woods. The patient was initially hemodynamically stable but developed cardiogenic shock from sick sinus syndrome. The patient's shock was non-responsive to IV fluid resuscitation and required ICU admission. Congestive heart failure, ischemic cardiomyopathy, substance abuse, myocarditis, and endocarditis were considered but ruled out. Patient's symptoms improved after electrolyte repletion following brief ICU admission with dopamine drip.
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http://dx.doi.org/10.7759/cureus.14625 | DOI Listing |
Nutr Clin Pract
February 2025
Institute of Human Nutrition and Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
COVID-19 has spread worldwide and significantly influenced economies. Refeeding syndrome (RFS) is a potentially fatal abnormalities of electrolytes and fluid that can occur in malnourished patients undergoing mechanical refeeding. Herein, we report the case of a man in his 20s with a normal body mass index who presented with RFS and vitamin B1 deficiency.
View Article and Find Full Text PDFNutr Clin Pract
December 2024
Department of Surgery, Oregon Health Sciences University, Portland, Oregon, USA.
Severe acute pancreatitis often presents as a complex critical illness associated with a high rate of infectious morbidity, multiple organ failure, and in-hospital mortality. Breakdown of gut barrier defenses, dysbiosis of intestinal microbiota, and exaggerated immune responses dictate that early enteral nutrition (EN) is preferred over parenteral nutrition (PN) as the primary route of nutrition therapy. EN, however, is not feasible in all cases because of intolerance, risk of complications, or a direct contraindication to enteral feeding.
View Article and Find Full Text PDFGE Port J Gastroenterol
December 2024
GENE - Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal.
Background: Short bowel syndrome (SBS) is a devastating malabsorptive condition and the most common cause of chronic intestinal failure (CIF). During the intestinal rehabilitation process, patients may need parenteral support for months or years, parenteral nutrition (PN), or hydration/electrolyte supplementation, as a bridge for the desired enteral autonomy.
Summary: Several classification criteria have been highlighted to reflect different perspectives in CIF.
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