Central neurogenic hyperventilation with acute respiratory alkalosis, transient lactic acidosis and tachycardia following endoscopic third ventriculostomy in a child- A Case Report
Keywords:
third ventriculostomy, respiratory alkalosis, central neurogenic hyperventilation, saline irrigation
Abstract
Background: Central neurogenic hyperventilation (CNH) is a rare but well documented complication after endoscopic third ventriculostomy (ETV) in adults. Case Characteristics: 6 year old developed CNH, acute respiratory alkalosis, intraoperative tachycardia and lactic acidosis following ETV for a pineal gland tumour causing obstructive hydrocephalus. Observations: Attributed to irritation of the hypothalamus while irrigating the floor of the thrid ventricle with normal saline. Outcome: Treatment with sedation and oxygen via rebreathing mask resulted in normalization of symptoms and blood gas. Message: CNH can occur in children following ETV and should be recognized early. Measurement of ICP during ETV and use of alternative irrigation fluids such as lactated ringer#x2019;s or artificial CSF may minimize occurrence.
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2016-03-15
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