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Question

hi we have gota baby of annalaxmi in our nicu .the baby got transferred from pnc ward in view of jitteriness and excessive cry.reports suggested hypocalcemia ,was strated on inj ca gluconate .rpt ca report showed normal values. till the first 3 days the baby was ok but on the third day c/t/a was depressed .rpt cbc and platelets showed drop in the platelet count,was stared on inj meropenem and inj ciplox i/v/o sepsis ,on the next day baby had slow irregular respiration rr:20-28 with episodes of apnoea in between,3 abgs consistently showed metabolic alkalosis like picture with normal o2 saturation and normal po2 pco2 levels.now the baby is off oxygen but is not fuuly active abd still showing metabolic alkalosis what should be done further,the serum electrolytes report was normal blood culture shows no growth done twice

Answer

Rule out Barters syndrome, Gitelman syndrome, Cystic fibrosis and congenital adrenal hyperplasia. Do plasma renin and aldosterone.
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