Respiratory Alkalosis

• Causes
  1. Increased Central Respiratory Drive
     1. Anxiety
     2. CNS Infection
     3. Cerebrovascular Accident
     4. Brain tumor
     5. Head Trauma
     6. Medications
        1. Salicylates
        2. Nicotine
        3. Aminophylline
        4. Progesterone
        5. Catecholamines
     7. Fever
     8. Sepsis (especially with Gram Negative Bacteria)
     9. Pregnancy
     10. Liver failure, Cirrhosis or Hepatic Encephalopathy
     11. Hyperthyroidism
  2. Increased Chemoreceptor Stimulation
     1. Anemia
     2. Carbon Monoxide Poisoning
     3. Pulmonary edema
     4. Pneumonia
     5. Pulmonary Embolism
     6. High altitude (decreased FIO2)
     7. Restrictive lung disease (early)
  3. Iatrogenic with Mechanical Ventilation

   

   

• Labs
  1. Arterial Blood Gas
     1. Arterial pH increased
     2. Serum bicarbonate decreased
     3. PaCO2 decreased decreased
  2. Acute Respiratory Alkalosis
     1. PaCO2 decrease by 10 mmHg increases pH by 0.08
     2. Bicarbonate decreases 2 meq/L per 10 mmHg PaCO2 fall
  3. Chronic Respiratory Alkalosis
     1. PaCO2 decrease by 10 mmHg increases pH by 0.03
     2. Bicarbonate decreases 4 meq/L per 10 mmHg PaCO2 fall