Among critically ill surgical patients, caloric provision across a wide acceptable range does not appear to be associated with major outcomes, including infectious complications. The optimum target for caloric provision remains elusive.

The addition of glutamine to standard enteral feeds or to an immunomodulatory formula did not improve outcomes. These findings suggest that enteral glutamine should not be routinely administered to patients with surgical critical illness.

Weight loss surgery can provide many health benefits to those suffering from morbid obesity. The surgery, however, is not without potential complications. This clinical observation describes a patient who experienced gait disturbances, lower extremity weakness, and neuropathy which led to a diagnosis of copper deficiency less than 2 years following a Roux-en-Y gastric bypass. Neurological symptoms were improved within 2 months of copper supplementation. The need to monitor patients for less common micronutrient deficiencies such as copper following Roux-en-Y gastric bypass is reinforced by this case.