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respiratory alkalosis

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Lungs and bronchial tree

Alternative Names
hyperventilation-induced alkalosis

Definition
Alkalosis describes a condition in which the amount of acid in the body is reduced. It may be due to breathing too fast, which is called respiratory alkalosis.

What is going on in the body?
The kidneys and lungs work to keep the level of acid in the body at a constant level. The kidneys can get rid of acid in the urine and the lungs can get rid of acid in the form of carbon dioxide gas. Many different conditions can cause the lungs to breathe out more carbon dioxide than usual.

What are the signs and symptoms of the condition?
An individual with respiratory alkalosis breathes harder and faster than normal. If a person is breathing fast to get rid of extra acid in the body, this is usually the only symptom. If the level of acid is normal in the body, respiratory alkalosis may cause:
  • light-headedness or dizziness
  • numbness or tingling, especially in the hands, feet, and mouth
  • uncontrollable muscle spasms, which only occur in severe cases
The underlying cause may also result in symptoms.

What are the causes and risks of the condition?
There are many things that can cause too much acid in the body. Examples include dehydration, infection, not getting enough oxygen, certain toxins, and kidney problems. Respiratory alkalosis in these cases is a normal reaction of the body.

Abnormal cases, in which the level of acid in the body is normal, may be caused by:
  • anxiety
  • brain damage, such as head injury or a stroke
  • certain medications, such as aspirin
  • pregnancy, which usually causes only mild cases
  • liver failure, such as cirrhosis
  • inflammation or tumours in the central nervous system
What can be done to prevent the condition?
anxiety is one of the more common causes of abnormal fast breathing. It can be treated with psychotherapy and medication to prevent a person from hyperventilating. Aspirin and other medications should be taken only as directed.

One cause of respiratory alkalosis is exposure to high altitudes, known as acute mountain sickness. The low pressure at higher altitudes causes a person to have to breathe faster to get enough oxygen. The symptoms of fast breathing can be prevented with medications taken before a climb. Climbing slowly can also prevent symptoms, as it gives the body time to adjust.

How is the condition diagnosed?
The condition is suspected from the history and examination. A blood test, known as arterial blood gases, can measure the level of acid in the blood and help determine if the cause of a low acid level is breathing too fast.

What are the long-term effects of the condition?
There are generally no long-term effects to respiratory alkalosis. The underlying cause of the condition may, however, have quite serious effects. For example, the underlying cause may be brain damage.

What are the risks to others?
There are no risks to others, as this condition is not contagious.

What are the treatments for the condition?
If the respiratory alkalosis is a normal response from too much body acid, the cause of the extra acid needs to be treated. If the condition is caused by anxiety, the person can try putting a paper bag over his or her mouth. By rebreathing the air in the paper bag, the person may be able to stop the attack of fast breathing. Sedatives may also be needed to calm the person.

What are the side effects of the treatments?
Sedatives can cause drowsiness, allergic reactions, and other side effects, depending on the medication used.

What happens after treatment for the condition?
The person's life after treatment depends on the underlying cause. For example, if the underlying cause is brain damage, a person may need lifelong treatment. If the underlying cause can be fixed, no further treatment is needed.

How is the condition monitored?
Regular arterial blood gases may be used to monitor respiratory alkalosis. Any new or worsening symptoms should be reported to the doctor.

Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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