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Alkalosis, Respiratory

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

    • Chronic respiratory alkalosis occurs in pulmonary and liver disease

Epidemiology

  • • May be early sign of sepsis

Symptoms and Signs

  • • Paresthesias

    • Carpopedal spasm

    • Positive Chvostek sign

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

  • • ABG measurement

    • Serum electrolytes

  • • Chronic respiratory alkalosis does not generally require treatment

Complications

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

References

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Adrogue HJ et al. Management of life-threatening acid-base disorders. (Two parts.) N Engl J Med. 1998;338:26, 107.
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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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