Carbon Dioxide and Hemoglobin at Presentation with Hypertrophic Pyloric Stenosis—Are They Relevant? Cohort Study and Current Opinions
Background: Recurrent vomiting in infantile hypertrophic pyloric stenosis (IHPS) leads to metabolic alkalosis and a respiratory-driven compensatory hypercapnia. Alkalosis has been identified as the main causal factor for respiratory depression on admission. The value of contribution of hemoglobin an...
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MDPI AG
2025-07-01
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| author | Ralf-Bodo Tröbs Hiltrud Niggemann Grigore Cernaianu Andreas Lipphaus Matthias Nissen |
| author_facet | Ralf-Bodo Tröbs Hiltrud Niggemann Grigore Cernaianu Andreas Lipphaus Matthias Nissen |
| author_sort | Ralf-Bodo Tröbs |
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| description | Background: Recurrent vomiting in infantile hypertrophic pyloric stenosis (IHPS) leads to metabolic alkalosis and a respiratory-driven compensatory hypercapnia. Alkalosis has been identified as the main causal factor for respiratory depression on admission. The value of contribution of hemoglobin and carbon dioxide partial pressure to this phenomenon will be evaluated. Materials and Methods: A retrospective cohort study was conducted on 105 infants with IHPS. The acid/base status, including levels of hemoglobin and lactate, were recorded. Statistical comparisons, correlation analysis, linear regression and multivariate regression analysis were applied. Results: Hypercapnia was associated with hemoconcentration. We found a positive correlation was found between pCO<sub>2</sub> and hemoglobin (<i>p</i> = 0.042). The multivariate linear regression analysis showed that pCO<sub>2</sub> is dependent on hemoglobin (<i>p</i> = 0.002). Lactate, which is used as a marker for anaerobic glycolysis, showed no systematic correlation with pCO<sub>2</sub>. Conclusions: An increase in carbon dioxide cannot easily be attributed to a reduced transport function of carbon dioxide due to hemoglobin deficiency. Further investigation is needed to determine the extent to which low hemoglobin levels and increased pCO<sub>2</sub> interact with hemoconcentration to contribute to respiratory problems. |
| format | Article |
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| language | English |
| publishDate | 2025-07-01 |
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| spelling | doaj-art-b9854225d1b14780a025d4eab5a6ec992025-08-20T02:45:38ZengMDPI AGChildren2227-90672025-07-0112788510.3390/children12070885Carbon Dioxide and Hemoglobin at Presentation with Hypertrophic Pyloric Stenosis—Are They Relevant? Cohort Study and Current OpinionsRalf-Bodo Tröbs0Hiltrud Niggemann1Grigore Cernaianu2Andreas Lipphaus3Matthias Nissen4Department of General-, Visceral- and Pediatric Surgery, St. Vinzenz Krankenhaus, 33098 Paderborn, GermanyDivision of Pediatric Surgery, University Hospital Cologne, Kerpenerstr. 62, 50937 Köln, GermanyDivision of Pediatric Surgery, University Hospital Cologne, Kerpenerstr. 62, 50937 Köln, GermanyDepartment of Pediatric Surgery, Ruhr-University of Bochum, St. Marie’s Hospital Witten, Sankt Elisabeth Gruppe Herne, 58452 Witten, GermanyDepartment of Pediatric Surgery, Ruhr-University of Bochum, St. Marie’s Hospital Witten, Sankt Elisabeth Gruppe Herne, 58452 Witten, GermanyBackground: Recurrent vomiting in infantile hypertrophic pyloric stenosis (IHPS) leads to metabolic alkalosis and a respiratory-driven compensatory hypercapnia. Alkalosis has been identified as the main causal factor for respiratory depression on admission. The value of contribution of hemoglobin and carbon dioxide partial pressure to this phenomenon will be evaluated. Materials and Methods: A retrospective cohort study was conducted on 105 infants with IHPS. The acid/base status, including levels of hemoglobin and lactate, were recorded. Statistical comparisons, correlation analysis, linear regression and multivariate regression analysis were applied. Results: Hypercapnia was associated with hemoconcentration. We found a positive correlation was found between pCO<sub>2</sub> and hemoglobin (<i>p</i> = 0.042). The multivariate linear regression analysis showed that pCO<sub>2</sub> is dependent on hemoglobin (<i>p</i> = 0.002). Lactate, which is used as a marker for anaerobic glycolysis, showed no systematic correlation with pCO<sub>2</sub>. Conclusions: An increase in carbon dioxide cannot easily be attributed to a reduced transport function of carbon dioxide due to hemoglobin deficiency. Further investigation is needed to determine the extent to which low hemoglobin levels and increased pCO<sub>2</sub> interact with hemoconcentration to contribute to respiratory problems.https://www.mdpi.com/2227-9067/12/7/885infantile hypertrophic pyloric stenosiscarbon dioxidehemoglobinrespiratory depression |
| spellingShingle | Ralf-Bodo Tröbs Hiltrud Niggemann Grigore Cernaianu Andreas Lipphaus Matthias Nissen Carbon Dioxide and Hemoglobin at Presentation with Hypertrophic Pyloric Stenosis—Are They Relevant? Cohort Study and Current Opinions Children infantile hypertrophic pyloric stenosis carbon dioxide hemoglobin respiratory depression |
| title | Carbon Dioxide and Hemoglobin at Presentation with Hypertrophic Pyloric Stenosis—Are They Relevant? Cohort Study and Current Opinions |
| title_full | Carbon Dioxide and Hemoglobin at Presentation with Hypertrophic Pyloric Stenosis—Are They Relevant? Cohort Study and Current Opinions |
| title_fullStr | Carbon Dioxide and Hemoglobin at Presentation with Hypertrophic Pyloric Stenosis—Are They Relevant? Cohort Study and Current Opinions |
| title_full_unstemmed | Carbon Dioxide and Hemoglobin at Presentation with Hypertrophic Pyloric Stenosis—Are They Relevant? Cohort Study and Current Opinions |
| title_short | Carbon Dioxide and Hemoglobin at Presentation with Hypertrophic Pyloric Stenosis—Are They Relevant? Cohort Study and Current Opinions |
| title_sort | carbon dioxide and hemoglobin at presentation with hypertrophic pyloric stenosis are they relevant cohort study and current opinions |
| topic | infantile hypertrophic pyloric stenosis carbon dioxide hemoglobin respiratory depression |
| url | https://www.mdpi.com/2227-9067/12/7/885 |
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