Case reportSevere acidosis caused by starvation and stress
Section snippets
Case report
A 1-year-old African-American boy, with a medical history of mild gastroesophageal reflux and mild asthma, was brought to Children’s Hospital of Wisconsin via ambulance after a cardiac arrest. He was in his usual state of good health the morning of admission, but around 2 pm he was discovered unresponsive at daycare. He was not breathing, and no pulse was detected. The daycare worker initiated cardiopulmonary resuscitation. Emergency medical services reestablished a pulse after 30 minutes. On
Discussion
We have described a 1-year-old boy with severe anoxic brain injury who received no glucose or any other nutrition for over 5 days. Dextrose was withheld because of the potential deleterious effects of hyperglycemia after ischemic brain injury. The patient initially had an increased gap metabolic acidosis, probably secondary to lactic acidosis from hypoxia, but this resolved quickly with fluid resuscitation. Beginning on day 2 after admission, the patient had a metabolic acidosis that was
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