Respiratory problems owing to severe metabolic alkalosis in infants presenting with hypertrophic pyloric stenosis

This retrospective study of 459 IHPS patients found that 5% developed preoperative respiratory problems, with significantly higher risk associated with elevated bicarbonate levels (OR 2.18 per 10 mmol/L increase). Findings suggest lowering bicarbonate targets before surgery and implementing respiratory monitoring may reduce perioperative apnea risk.