Hypokalaemic, hyperchloraemic metabolic acidosis requiring ventilation

A 16-year-old patient required intermittent positive pressure ventilation for hypokalaemic muscle weakness resulting from metabolic complications of combined colonic bladder augmentation and incomplete voiding via a prosthetic sphincter. Catheter re-establishment of urinary flow and electrolyte replacement produced dramatic metabolic and clinical improvement allowing the return of adequate spontaneous respiration.