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, 79 (10), 1296-9

Marked Hypochloremic Metabolic Alkalosis With Severe Compensatory Hypoventilation

Case Reports

Marked Hypochloremic Metabolic Alkalosis With Severe Compensatory Hypoventilation

C J Lavie et al. South Med J.

Abstract

In metabolic alkalosis, a compensatory decrease in alveolar ventilation with hypercapnia has been noted only rarely. We recently managed a patient with gastric outlet obstruction from a duodenal ulcer who survived after arriving in the emergency room comatose with severe hypochloremic metabolic alkalosis, compensatory hypoventilation, and hypercapnia. We know of no report in the English literature of a patient with gastric outlet obstruction having a respiratory acidosis or hypochloremia as severe as that in our patient. Proper understanding of the pathophysiology of primary metabolic alkalosis due to gastric losses is necessary to correct the acid-base abnormalities quickly and to restore normal alveolar ventilation.

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