Severe Hypercapnia Associated With Metabolic Alkalosis Due to Pyloric Stenosis

Abstract

Summary: A patient with severe hypercapnia (PaCO 2 = 75 mm Hg) secondary to metabolic alkalosis is described. The patient had normal sensitivity to inhaled carbon dioxide after recovery. The hypercapnia was considered to be caused by a combination of severe metabolic alkalosis, hypochloraemia, hypokalaemia, de‐hydration and azotaemia, all of which were secondary to persistent vomiting caused by pyloric stenosis. The mechanisms of ventilatory depression during alkalosis, including the roles of hypochloraemia and hydrogen ion depletion, are discussed.