title: Marked hypochloremic metabolic alkalosis with severe compensatory hypoventilation.
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.
mesh_terms: D000471:Alkalosis / Q000097:blood / Q000209:etiology*; D002713:Chlorine / Q000097:blood; D004381:Duodenal Ulcer / Q000097:blood / Q000150:complications*; D006801:Humans; D006935:Hypercapnia / Q000097:blood / Q000209:etiology; D007040:Hypoventilation / Q000097:blood / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011708:Pylorus; D013272:Stomach Diseases / Q000097:blood / Q000209:etiology
chemical_list: D002713:Chlorine