Skip to main content

Respiratory Alkalosis

  • 2197 Accesses

Abstract

A. A. is a 27-year-old woman with asthma who presents to the emergency room with cough and dyspnea. The cough began approximately 2 weeks ago after the onset of “cold” symptoms. Her symptoms (sore throat, runny nose, and congestion) have resolved, but the cough has persisted. Since last night, she has felt increasing shortness of breath and “tightness” in her chest. She is breathing at a rate of 28 breaths per min and her oxygen saturation is 97 % while breathing room air. Auscultation of the chest reveals diffuse expiratory wheezing. Electrolytes and complete blood cell counts are within normal limits, and the chest X-ray shows no pulmonary opacities. Analysis of the arterial blood gas reveals: pH 7.5, pCO2 25 mmHg, and HCO 3 20 mEq/L.

Keywords

  • Respiratory Alkalosis
  • Runny Nose
  • Primary Disorder
  • Alcoholic Liver Cirrhosis
  • Base Disorder

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-1-4614-4454-1_15
  • Chapter length: 6 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   189.00
Price excludes VAT (USA)
  • ISBN: 978-1-4614-4454-1
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   249.99
Price excludes VAT (USA)
Hardcover Book
USD   349.99
Price excludes VAT (USA)
Fig. 15.1

References

  1. Mazzara JT, Ayres SM, Grace WJ. Extreme hypocapnia in the critically ill patient. Am J Med. 1974;56(4):450–6.

    PubMed  CrossRef  CAS  Google Scholar 

  2. Hodgkin JE, Soeprono FF, Chan DM. Incidence of metabolic alkalemia in hospitalized patients. Crit Care Med. 1980;8(12):725–8.

    PubMed  CrossRef  CAS  Google Scholar 

  3. Palange P, Carlone S, Galassetti P, Felli A, Serra P. Incidence of acid-base and electrolyte disturbances in a general hospital: a study of 110 consecutive admissions. Recenti Prog Med. 1990;81(12):788–91.

    PubMed  CAS  Google Scholar 

  4. Nadel JA, Murray JF, Mason RJ. Murray and Nadel’s textbook of respiratory medicine. 4th ed. Philadelphia: Elsevier Saunders; 2005.

    Google Scholar 

  5. Harrison TR, Braunwald E. Harrison’s principles of internal medicine. 15th ed. New York: McGraw-Hill; 2001.

    Google Scholar 

  6. Lepper EH, Martland M. Variations in the p(H) and bicarbonate of the plasma and of the alveolar CO(2) during forced breathing. Biochem J. 1927;21(4):823–30.

    PubMed  CAS  Google Scholar 

  7. Brown Jr EB. Physiological effects of hyperventilation. Physiol Rev. 1953;33(4):445–71.

    PubMed  CAS  Google Scholar 

  8. Gennari FJ, Goldstein MB, Schwartz WB. The nature of the renal adaptation to chronic hypocapnia. J Clin Invest. 1972;51(7):1722–30.

    PubMed  CrossRef  CAS  Google Scholar 

  9. Krapf R, Beeler I, Hertner D, Hulter HN. Chronic respiratory alkalosis. The effect of sustained hyperventilation on renal regulation of acid-base equilibrium. N Engl J Med. 1991;324(20):1394–401.

    PubMed  CrossRef  CAS  Google Scholar 

  10. Gardner WN. Hyperventilation. Am J Respir Crit Care Med. 2004;170(2):105–6.

    PubMed  CrossRef  Google Scholar 

  11. Gardner WN. The pathophysiology of hyperventilation disorders. Chest. 1996;109(2):516–34.

    PubMed  CrossRef  CAS  Google Scholar 

  12. Engel LA, Ritchie B. Ventilatory response to inhaled carbon dioxide in hyperthyroidism. J Appl Physiol. 1971;30(2):173–7.

    PubMed  CAS  Google Scholar 

  13. Osborne CA, O’Connor BJ, Lewis A, Kanabar V, Gardner WN. Hyperventilation and asymptomatic chronic asthma. Thorax. 2000;55(12):1016–22.

    PubMed  CrossRef  CAS  Google Scholar 

  14. Saisch SG, Wessely S, Gardner WN. Patients with acute hyperventilation presenting to an inner-city emergency department. Chest. 1996;110(4):952–7.

    PubMed  CrossRef  CAS  Google Scholar 

  15. Damas-Mora J, Davies L, Taylor W, Jenner FA. Menstrual respiratory changes and symptoms. Br J Psychiatry. 1980;136:492–7.

    PubMed  CrossRef  CAS  Google Scholar 

  16. Hannhart B, Pickett CK, Moore LG. Effects of estrogen and progesterone on carotid body neural output responsiveness to hypoxia. J Appl Physiol. 1990;68(5):1909–16.

    PubMed  CAS  Google Scholar 

  17. Kerr WJ, Gliebe PA, Dalton JW. Physical phenomena associated with anxiety states: the hyperventilation syndrome. Cal West Med. 1938;48(1):12–6.

    PubMed  CAS  Google Scholar 

  18. Haldane JS, Poulton EP. The effects of want of oxygen on respiration. J Physiol. 1908;37(5–6):390–407.

    PubMed  CAS  Google Scholar 

  19. Raichle ME, Plum F. Hyperventilation and cerebral blood flow. Stroke. 1972;3(5):566–75.

    PubMed  CrossRef  CAS  Google Scholar 

  20. Kazmaier S, Weyland A, Buhre W, Stephan H, Rieke H, Filoda K, et al. Effects of respiratory alkalosis and acidosis on myocardial blood flow and metabolism in patients with coronary artery disease. Anesthesiology. 1998;89(4):831–7.

    PubMed  CrossRef  CAS  Google Scholar 

  21. Saltzman HA, Heyman A, Sieker HO. Correlation of clinical and physiologic manifestations of sustained hyperventilation. N Engl J Med. 1963;268:1431–6.

    PubMed  CrossRef  CAS  Google Scholar 

  22. Rafferty GF, Saisch SG, Gardner WN. Relation of hypocapnic symptoms to rate of fall of end-tidal PCO2 in normal subjects. Respir Med. 1992;86(4):335–40.

    PubMed  CrossRef  CAS  Google Scholar 

  23. Arbus GS, Herbert LA, Levesque PR, Etsten BE, Schwartz WB. Characterization and clinical application of the “significance band” for acute respiratory alkalosis. N Engl J Med. 1969;280(3):117–23.

    PubMed  CrossRef  CAS  Google Scholar 

  24. Jones NL, Robertson DG, Kane JW. Difference between end-tidal and arterial PCO2 in exercise. J Appl Physiol. 1979;47(5):954–60.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shirin Shafazand M.D., M.S. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Toonkel, R.L., Shafazand, S. (2013). Respiratory Alkalosis. In: Lerma, E., Rosner, M. (eds) Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4454-1_15

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-4454-1_15

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-4453-4

  • Online ISBN: 978-1-4614-4454-1

  • eBook Packages: MedicineMedicine (R0)