title: Hypertrophic pyloric stenosis: predicting the resolution of biochemical abnormalities.
abstract: OBJECTIVE
  Hypertrophic pyloric stenosis (HPS) is a common condition of infancy, often presenting with marked biochemical derangement, requiring correction. Previous studies have looked at the relationship between serum electrolytes and acid-base balance in HPS but not at the relationship between the degree of biochemical derangement and time taken to resolve the biochemical abnormality.
  
  
  METHODS
  Retrospective analysis was performed on all 151 infants undergoing pyloromyotomy over a 3 year period. Of these, 105 met the inclusion criteria of: compliance with the unit HPS fluid protocol, and the documentation of at least three serial biochemical investigations. The rate of correction for each biochemical marker (sodium, potassium, chloride, urea, pCO2, hydrogen ion concentration, bicarbonate and the base excess) was plotted against the degree of disturbance and then against time.
  
  
  RESULTS
  A significant relationship (P < 0.01) was found between the rate of correction of an abnormal chloride, urea or base excess and the degree of initial derangement. This enables the prediction of the time taken for the required correction of biochemical abnormalities prior to theatre.
  
  
  CONCLUSIONS
  This method of analysis may be of value in comparing the effectiveness of different fluid regimes in use for the correction of biochemical abnormalities in infants with IHPS.
authors.affiliation: Alder Hey Children's Hospital, Liverpool, UK. d.wilkinson1@mac.com
authors.forename: David J
authors.initials: DJ
authors.lastname: Wilkinson
authors.forename: Richard A
authors.initials: RA
authors.lastname: Chapman
authors.forename: Anthony
authors.initials: A
authors.lastname: Owen
authors.forename: Simon
authors.initials: S
authors.lastname: Olpin
authors.forename: Sean S
authors.initials: SS
authors.lastname: Marven
mesh_terms: D000137:Acid-Base Imbalance / Q000209:etiology / Q000378:metabolism* / Q000628:therapy; D002712:Chlorides / Q000097:blood; D013505:Digestive System Surgical Procedures / Q000379:methods; D018450:Disease Progression; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011188:Potassium / Q000097:blood; D011379:Prognosis; D046248:Pyloric Stenosis, Hypertrophic / Q000150:complications / Q000378:metabolism* / Q000628:therapy; D011708:Pylorus / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood
chemical_list: D002712:Chlorides; D012964:Sodium; D011188:Potassium