Pathophysiology of hypertrophic pyloric stenosis revisited
- Background: The aim of this study was to elucidate the preoperative clinical and biochemical profile of infants with IHPS to optimize infusion therapy. Patients and Method: We retrospectively analyzed data from 56 infants who were operated for IHPS. Our study includes growth and laboratory data prior to the initiation of therapy. Results: Median duration of propulsive vomiting was 4 d; the median age was 37 d (18-108), and the median body weight was 3840 g (2760-5900). Metabolic alkalosis (MAlk) with a pH of 7.45 \(\pm\) 0.06 and an stHCO\(^{-}\)\(_{3}\) of 28.7 \(\pm\) 4.5 mmol/l was found. In a subgroup of the infants, negative base excess (BE) was observed. The sodium concentration was normal or reduced (mean/median of 137 mmol/l). There was a strong negative correlation between stHCO\(^{-}\)\(_{3}\) and K\(^{+}\). The carbon dioxide partial pressure tended to increase (5.72 \(\pm\) 0.84 kPa). Calculations of osmolality revealed a normal osmolarity. Hypoglycemia did not occur. The creatinine clearance according to the Schwartz formula remained at a normal level (85.3 \(\pm\) 24.3 ml/min/1.73 m\(^{2}\)). Discussion: The presented case series is characterized by a short duration of preoperative vomiting. MAlk can be classified as a chloride deficiency syndrome. It is accompanied by normo- or hyponatremic dehydration with normal osmolality. Partial respiratory compensation occurred. A normal creatinine clearance indicated good glomerular renal function. Conclusion: The presented study supports the use of an isotonic infusion fluid with a low glucose concentration for preoperative infusion therapy.
Author: | Ralf-Bodo TröbsGND |
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URN: | urn:nbn:de:hbz:294-57675 |
DOI: | https://doi.org/10.4236/ojped.2014.43027 |
Parent Title (English): | Open journal of pediatrics |
Subtitle (English): | the use of isotonic fluid for preoperative infusion therapy is supported |
Document Type: | Article |
Language: | English |
Date of Publication (online): | 2018/06/27 |
Date of first Publication: | 2014/09/03 |
Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
Tag: | Open Access Fonds Creatinine Clearance; Dehydration; Glucose; Infantile Pyloric Stenosis; Infusion Therapy; Lactate; Metabolic Alkalosis; Osmolality |
Volume: | 4 |
Issue: | 3 |
First Page: | 208 |
Last Page: | 215 |
Note: | Article Processing Charge funded by the Deutsche Forschungsgemeinschaft (DFG) and the Open Access Publication Fund of Ruhr-Universität Bochum. |
Institutes/Facilities: | Marienhospital Herne, Klinik für Kinderchirurgie |
Dewey Decimal Classification: | Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit |
open_access (DINI-Set): | open_access |
faculties: | Medizinische Fakultät |
Licence (English): | Creative Commons - CC BY 4.0 - Attribution 4.0 International |