1. Rarely life threatening, but underlying cause must be treated.
2. If patient is mechanically ventilated, consider reducing minute ventilation by reducing ventilator rate, inspiratory volume, or pressure. Adequate sedation may be required if a patient-triggered ventilator mode of ventilation is used.
VI. Problem Case Diagnosis. The 3-week-old infant was diagnosed with hypertrophic pyloric stenosis. Laboratory tests showed hypochloremic, hypokalemic alkalosis; and a thickened pylorus was visualized on abdominal ultrasound.
VII. Teaching Pearl: Question. What disorder and test must be considered in an ill-appearing, lethargic neonate with respiratory alkalosis?
VIII. Teaching Pearl: Answer. Urea cycle disorder and ammonia level must be considered; obtain serum ammonia level.
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