Respiratory alkalosis Contents Signs and symptoms Causes Mechanism Diagnosis Treatment Society See also References Further reading External links Navigation menu"Respiratory alkalosis: MedlinePlus Medical Encyclopedia""Respiratory Alkalosis: Background, Pathophysiology, Epidemiology""Blood gas analysis for bedside diagnosis"10.4103/0975-5950.1276410975-5950396188524665166Essentials of Pathophysiology: Concepts of Altered Health StatesFluid and Electrolytes in Pediatrics: A Comprehensive Handbook"Alkalosis: MedlinePlus Medical Encyclopedia""Hyperventilation: MedlinePlus Medical Encyclopedia""Medscape: Medscape Access""Evaluation of respiratory alkalosis"Pathophysiology: A 2-in-1 Reference for NursesClinical Respiratory Medicine10.1681/ASN.200912121120431042Fluid and Electrolyte BalanceThe Washington Manual of SurgeryHandbook of Medical-surgical Nursing"AFI: Robert Wise - Andromeda Strain"Encyclopedia of Molecular Mechanisms of Disease: With 213 Tables"The effects of respiratory alkalosis and acidosis on net bicarbonate flux along the rat loop of Henle in vivo"1931-857X9374832"Effects of respiratory alkalosis on human skeletal muscle metabolism at the onset of submaximal exercise"10.1113/jphysiol.2002.0227640022-3751229056112356901E87.3276.3D000472406000111med/2009ee

Volume contractiondehydrationhypovolemiaHypervolemiaHypernatremiaSalt poisoningLowHypotonicIsotonicHighLowHighLowHighLowMetabolicHigh anion gapKetoacidosisDiabetic ketoacidosisAlcoholic ketoacidosisLacticNormal anion gapHyperchloremicRenal tubularRespiratoryMetabolicContraction alkalosisRespiratoryMixed disorder of acid-base balance


Acid–base disturbances


pHcarbon dioxideacid–base homeostasisalveolarCO2chemical equilibriumcarbonic acidcarbonic anhydrasepHDavenport diagramchronicacutemetabolic acidosismechanical ventilator












Respiratory alkalosis
Davenport Fig 11.jpg

Davenport diagram outlines pH and bicarbonate levels
Specialty
Endocrinology Edit this on Wikidata
CausesHyperventilation,[1] Pulmonary disorder[2]
Diagnostic methodChest x-ray, Pulmonary function tests [1]
TreatmentDetect underlying cause[1]

Respiratory alkalosis is a medical condition in which increased respiration elevates the blood pH beyond the normal range (7.35–7.45) with a concurrent reduction in arterial levels of carbon dioxide.[1][3] This condition is one of the four basic categories of disruption of acid–base homeostasis.[medical citation needed]




Contents





  • 1 Signs and symptoms


  • 2 Causes


  • 3 Mechanism


  • 4 Diagnosis

    • 4.1 Classification

      • 4.1.1 Ph




  • 5 Treatment


  • 6 Society


  • 7 See also


  • 8 References


  • 9 Further reading


  • 10 External links




Signs and symptoms




Signs and symptoms of respiratory alkalosis are as follows:[4]


  • Palpitation

  • Tetany

  • Convulsion

  • Sweating


Causes


Respiratory alkalosis may be produced as a result of the following causes:




  • Stress[1]


  • Pulmonary disorder[2]

  • Thermal insult[5]


  • High altitude areas[6]


  • Salicylate poisoning (aspirin overdose) [6]


  • Fever[1]


  • Hyperventilation (due to heart disorder or other, including improper mechanical ventilation)[1][7]

  • Vocal cord paralysis (compensation for loss of vocal volume results in over-breathing/breathlessness).[8]


  • Liver disease[6]



Mechanism




Carbonic-acid


The mechanism of respiratory alkalosis generally occurs when some stimulus makes a person hyperventilate. The increased breathing produces increased alveolar respiration, expelling CO2 from the circulation. This alters the dynamic chemical equilibrium of carbon dioxide in the circulatory system. Circulating hydrogen ions and bicarbonate are shifted through the carbonic acid (H2CO3) intermediate to make more CO2 via the enzyme carbonic anhydrase according to the following reaction: HCO3−+H+→H2CO3→CO2+H2Odisplaystyle rm HCO_3^-+H^+rightarrow H_2CO_3rightarrow CO_2+H_2O This causes decreased circulating hydrogen ion concentration, and increased pH (alkalosis).[9][10]



Diagnosis


The diagnosis of respiratory alkalosis is done via test that measure the oxygen and carbon dioxide levels (in the blood), chest x-ray and a pulmonary function test of the individual.[1]


The Davenport diagram allows clinicians or investigators to outline blood bicarbonate concentrations (and blood pH) after a respiratory or metabolic acid-base disturbance[11]



Classification


There are two types of respiratory alkalosis: chronic and acute as a result of the 3-5 day delay in kidney compensation of the abnormality.[12][2]



  • Acute respiratory alkalosis occurs rapidly, have a high pH because the response of the kidneys is slow.[13]


  • Chronic respiratory alkalosis is a more long-standing condition, here one finds the kidneys have time to decrease the bicarbonate level.[13]


Ph



  • Alkalosis refers to the process due to which there is elevation of blood pH.[6]


  • Alkalemia refers to an arterial blood pH of greater than 7.45.[14]


Treatment


Respiratory alkalosis is very rarely life-threatening, though pH level should not be 7.5 or greater. The aim in treatment is to detect the underlying cause. When PaCO2 is adjusted rapidly in individuals with chronic respiratory alkalosis, metabolic acidosis may occur.[2] If the individual is on a mechanical ventilator then preventing hyperventilation is done via monitoring ABG levels.[15]



Society


In The Andromeda Strain, one of the characters is exposed to contamination, but saves himself by increasing his breathing rhythm until he has respiratory alkalosis in his blood.[16]



See also



  • Acidosis

  • Alkalosis

  • Arterial blood gas

  • Chemical equilibrium

  • Hypocalcemia

  • Metabolic acidosis

  • Metabolic alkalosis

  • pCO2

  • pH

  • pKa

  • Respiratory acidosis



References




  1. ^ abcdefgh "Respiratory alkalosis: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2016-02-12..mw-parser-output cite.citationfont-style:inherit.mw-parser-output .citation qquotes:"""""""'""'".mw-parser-output .citation .cs1-lock-free abackground:url("//upload.wikimedia.org/wikipedia/commons/thumb/6/65/Lock-green.svg/9px-Lock-green.svg.png")no-repeat;background-position:right .1em center.mw-parser-output .citation .cs1-lock-limited a,.mw-parser-output .citation .cs1-lock-registration abackground:url("//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Lock-gray-alt-2.svg/9px-Lock-gray-alt-2.svg.png")no-repeat;background-position:right .1em center.mw-parser-output .citation .cs1-lock-subscription abackground:url("//upload.wikimedia.org/wikipedia/commons/thumb/a/aa/Lock-red-alt-2.svg/9px-Lock-red-alt-2.svg.png")no-repeat;background-position:right .1em center.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registrationcolor:#555.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration spanborder-bottom:1px dotted;cursor:help.mw-parser-output .cs1-ws-icon abackground:url("//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/12px-Wikisource-logo.svg.png")no-repeat;background-position:right .1em center.mw-parser-output code.cs1-codecolor:inherit;background:inherit;border:inherit;padding:inherit.mw-parser-output .cs1-hidden-errordisplay:none;font-size:100%.mw-parser-output .cs1-visible-errorfont-size:100%.mw-parser-output .cs1-maintdisplay:none;color:#33aa33;margin-left:0.3em.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-formatfont-size:95%.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-leftpadding-left:0.2em.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-rightpadding-right:0.2em


  2. ^ abcd "Respiratory Alkalosis: Background, Pathophysiology, Epidemiology". 2018-10-04.


  3. ^ Singh, Virendra; Khatana, Shruti; Gupta, Pranav (2013-01-01). "Blood gas analysis for bedside diagnosis". National Journal of Maxillofacial Surgery. 4 (2): 136–141. doi:10.4103/0975-5950.127641. ISSN 0975-5950. PMC 3961885. PMID 24665166.


  4. ^ Porth, Carol (2011-01-01). Essentials of Pathophysiology: Concepts of Altered Health States. Lippincott Williams & Wilkins. p. 205. ISBN 9781582557243.


  5. ^ Feld, Leonard G.; Kaskel, Frederick J. (2009-12-15). Fluid and Electrolytes in Pediatrics: A Comprehensive Handbook. Springer Science & Business. p. 280. ISBN 9781603272254.


  6. ^ abcd "Alkalosis: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2016-02-12.


  7. ^ "Hyperventilation: MedlinePlus Medical Encyclopedia".


  8. ^ "Medscape: Medscape Access". Medscape. 2018-04-05.


  9. ^ "Evaluation of respiratory alkalosis". us.bestpractice.bmj.com. Retrieved 2016-02-12.


  10. ^ Wilkins, Lippincott Williams & (2005-01-01). Pathophysiology: A 2-in-1 Reference for Nurses. Lippincott Williams & Wilkins. p. 102. ISBN 9781582553177.


  11. ^ Albert, Richard K.; Spiro, Stephen G.; Jett, James R. (2008-01-01). Clinical Respiratory Medicine. Elsevier Health Sciences. p. 128. ISBN 978-0323048255.


  12. ^ Adrogué, HJ; Madias, NE (June 2010). "Secondary responses to altered acid-base status: the rules of engagement". Journal of the American Society of Nephrology : JASN. 21 (6): 920–3. doi:10.1681/ASN.2009121211. PMID 20431042.


  13. ^ ab Metheny, Norma M. (2011-01-07). Fluid and Electrolyte Balance. Jones & Bartlett Publishers. p. 148. ISBN 9780763781644.


  14. ^ Klingensmith, Mary E. (2015-10-28). The Washington Manual of Surgery. Lippincott Williams & Wilkins. p. 87. ISBN 9781496310798.


  15. ^ Handbook of Medical-surgical Nursing. Lippincott Williams & Wilkins. 2006-01-01. p. 801. ISBN 9781582554457.


  16. ^ "AFI: Robert Wise - Andromeda Strain".




Further reading



  • Lang, Florian (2009-03-19). Encyclopedia of Molecular Mechanisms of Disease: With 213 Tables. Springer Science & Business Media. ISBN 9783540671367.


  • Unwin, R.; Stidwell, R.; Taylor, S.; Capasso, G. (1997-11-01). "The effects of respiratory alkalosis and acidosis on net bicarbonate flux along the rat loop of Henle in vivo". American Journal of Physiology. Renal Physiology. 273 (5): F698–F705. ISSN 1931-857X. PMID 9374832.


  • LeBlanc, P J; Parolin, M L; Jones, N L; Heigenhauser, G J F (2002-10-01). "Effects of respiratory alkalosis on human skeletal muscle metabolism at the onset of submaximal exercise". The Journal of Physiology. 544 (Pt 1): 303–313. doi:10.1113/jphysiol.2002.022764. ISSN 0022-3751. PMC 2290561. PMID 12356901.


External links






Classification
D


  • ICD-10: E87.3


  • ICD-9-CM: 276.3


  • MeSH: D000472


  • DiseasesDB: 406


External resources

  • MedlinePlus: 000111


  • eMedicine: med/2009









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