The combination of an increased serum total co2 content and lowered levels of serum chloride may result from a primary retention of co2 as in cardiopulmonary disease with a secondary lowering of the chloride level, referred to as respiratory acidosis, or it may represent one of the two forms of metabolic alkalosis, i.e., the hypochloremic type stemming from losses of extracellular chloride rath...

An endoscopic third ventriculostomy was performed in a 55-year-old man with an obstructive hydrocephalus due to aqueductal stenosis. The vital signs and laboratory studies upon admission were within the normal limits. Anesthesia was maintained with nitrous oxide in oxygen and 6% desflurane. The patient received irrigation with approximately 3,000 ml normal saline during the procedure. Anesthesi...

Most cases of hypercalcaemia are secondary to malignancy or primary hyperparathyroidism. We report a patient presenting with a triad of hypercalcemia, metabolic alkalosis, and renal failure secondary to treatment of iatrogenic hypoparathyroidism and osteoporosis. Persistent ingestion of calcium carbonate and vitamin D caused milk-alkali syndrome. The patient was managed with intravenous fluids ...

A known case of nephrotic syndrome aged 32 months was admitted to ICU because of loss of consciousness. In physical exam he had tachycardia, tachypnea and hypotension. Lab data showed metabolic alkalosis and hypoxia. In CXR, vascular cut off was seen in right lung and perfusion lung scan showed absence of perfusion in the right lung.Treatment was started with heparin and streptokinase, bu...

The effects, on respiration, of the acute administration of sodium bicarbonate were studied in 10 normal subjects. Carbon dioxide responses curves and tidal volume v. PCO2 relationships were obtained under hyperoxic conditions using a closed-circuit breathing system. During alkalosis, a decrease in the slope, and a displacement of the response curves to the right, were observed. These findings ...

A 22-day-old healthy appearing male infant presented with persistent vomiting after feeding with onset shortly after birth. This is the father’s second child and the mother’s first. Switching formulas had been unsuccessful. Abdominal X-ray (AXR) revealed a dilated air-filled stomach with a nonspecific bowel gas pattern (Fig. 1). Ultrasound (US) demonstrated a thick and elongated pylorus, confir...