PARENTERAL ADMINISTRATION OF AMMONIUM CHLORIDE FOR ALKALOSIS OF CONGENITAL HYPERTROPHIC PYLORIC STENOSIS

Abstract

IN A RECENT review¹ of the cases of congenital hypertrophic pyloric stenosis seen at the St. Louis Children's Hospital during the past twelve years, emphasis was placed on the proper preoperative preparation of the patient for the attainment of normal fluid and acid-base equilibriums. In the majority of patients these particular objectives can be satisfactorily realized by the administration of dextrose and isotonic solution of sodium chloride or isotonic solution of three chlorides U. S. P. (Ringer's solution). If sufficient water and electrolyte are given, a satisfactory adjustment can then be accomplished through renal activity. The relief of alkalosis by this means is at best a rather slow process, often requiring two or three or more days for its completion. Moreover, the entire process depends wholly on the renal function of the patient. If renal activity is impaired by persistence of anhydremia due to low plasma proteins or by preexisting