Respiratory alkalosis is a condition caused by hyperventilation, resulting in decreased carbon dioxide levels and bodily fluids becoming too alkaline. It can cause symptoms such as dizziness, tingling, and muscle contractions, and can be diagnosed through pH testing. Treatment depends on the underlying cause and may involve medication or oxygen therapy.
Respiratory alkalosis is a medical condition characterized by decreased serum carbon dioxide levels. Because the lungs, which are one of the two organs that regulate the acid-base ratio of pH in the body, are involved, respiratory alkalosis is also characterized by bodily fluids becoming too alkaline. While respiratory alkalosis is rarely life-threatening, it can sometimes lead to serious complications, such as seizures, heart arrhythmias, or loss of consciousness.
The mechanism behind respiratory alkalosis is quite simple. First, breathing very rapidly brings more oxygen into the lungs than usual. Normally, oxygen would be exchanged and exhaled as carbon dioxide. When breathing becomes labored, however, and the person struggles to get more air by breathing faster, this exchange doesn’t happen at the correct rate. This is what leads to abnormally low levels of carbon dioxide in the blood, which in turn causes the body’s pH to become too alkaline.
Several things can cause respiratory alkalosis to develop. The main cause is hyperventilation, which can result from various medical problems. For example, any type of lung disorder that causes shortness of breath can trigger this event. This includes asthma, chronic bronchitis, emphysema, or a combination of these disorders collectively labeled as chronic obstructive pulmonary disease (COPD). However, hyperventilation can also be caused by severe anxiety, panic attacks, fearful situations or phobias, or even in response to a fever.
The most common symptoms of respiratory alkalosis are dizziness and a tingling sensation in the fingers, toes, or face. Sometimes, hands may shake. Also, some people may experience nausea and/or vomiting. In extreme cases, muscles may twitch or contract into a state of tetany, which produces severe, involuntary muscle contractions. Occasionally, symptoms can progress to mental confusion or stupor and, in very rare cases, coma.
Diagnosis of respiratory alkalosis is made by observation of symptoms, followed by pH testing. Fluid pH analysis is determined by an arterial blood gas analysis, although a urinalysis may also be done. These tests also help the clinician determine whether a state of alkalosis was induced by a respiratory disorder or a metabolic disorder involving the kidneys.
Treatment is most relevant to the underlying cause of respiratory alkalosis and may involve medications to help control asthma or other respiratory disorders. In an emergency scenario, the immediate symptoms would certainly be addressed, usually by administering oxygen to the patient to raise the carbon dioxide levels and correct the pH of the fluid. At home, the patient can self-treat the condition by simply breathing into a paper bag. However, if confusion, seizures, or extreme breathing difficulties occur, a visit to the emergency room or a call to call for emergency paramedics is necessary.
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