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  • • Acute hyperventilation lowers Paco2 without concomitant changes in plasma bicarbonate concentration

    • Chronic respiratory alkalosis occurs in pulmonary and liver disease

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Epidemiology

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  • • May be early sign of sepsis

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Symptoms and Signs

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  • • Paresthesias

    • Carpopedal spasm

    • Positive Chvostek sign

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  • • Electrolyte pattern of chronic respiratory alkalosis is the same as hyperchloremic acidosis; they can only be distinguished by ABG pH measurement

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  • • ABG measurement

    • Serum electrolytes

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  • • Chronic respiratory alkalosis does not generally require treatment

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Complications

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  • • Treatment of chronic respiratory alkalosis may lead to metabolic acidosis and hyperchloremia

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References

Adrogue HJ et al. Management of life-threatening acid-base disorders. (Two parts.) N Engl J Med. 1998;338:26, 107.
Krapf R et al: Chronic respiratory alkalosis. The effect of sustained hyperventilation on renal regulation of acid-base equilibrium. N Engl J Med 1991;324:1394.  [PubMed: 1902283]

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