Radiographic and Other Studies

1. Chest x-ray. Pneumonic processes (pneumonia) resulting in hyperventilation may contribute to respiratory alkalosis. Patients with Pneumocystis carinii pneumonia, in particular, classically present with hypoxemia and respiratory alkalosis.

2. Upper GI and ultrasound scans. In the setting of progressive nonbilious emesis in an infant, it is necessary to rule out hypertrophic pyloric stenosis diagnosed by the classic "string sign" on upper GI series and increased length and thickness of pylorus on ultrasound.

V. Plan. Treatment is dependent on type of alkalosis and underlying cause. Alkalosis is a sign of a disorder and not the disease itself.

A. Volume Expansion. Give isotonic crystalloid solution for replacement of fluid losses as well as for maintenance. If hypokalemia is present, replace K+ with a chloride salt (KCl); there are safety limitations to KCl infusions.

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