What is Respiratory Alkalosis?

Karyn Maier

Respiratory alkalosis is a medical condition characterized by decreased serum levels of carbon dioxide. Since the lungs are involved, which are one of two organs that regulate the acid-to-base pH ratio in the body, respiratory alkalosis is also marked by body 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.

Mental confusion can be a sign of the progression of respiratory alkalosis.
Mental confusion can be a sign of the progression of respiratory alkalosis.

The mechanism behind respiratory alkalosis is quite simple. First, breathing very rapidly brings more oxygen into the lungs than usual. Normally, the 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 occur at the proper rate. This is what leads to abnormally low levels of carbon dioxide in the blood, which in turn causes the pH of the body to become too alkaline.

Respiratory alkalosis can be treated by breathing into a paper bag.
Respiratory alkalosis can be treated by breathing into a paper bag.

Several things may cause respiratory alkalosis to occur. The primary cause is hyperventilation, which may stem from various medical issues. For instance, 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 labeled collectively as chronic obstructive pulmonary disease (COPD). However, hyperventilation may also be caused by severe anxiety, panic attacks, experiencing fearful situations or phobias, or even in response to fever.

A urinalysis may be performed to rule out whether a metabolic disorder is causing the body to be too alkaline.
A urinalysis may be performed to rule out whether a metabolic disorder is causing the body to be too alkaline.

The most common symptoms of respiratory alkalosis are dizziness and feeling a tingling sensation in the fingers, toes, or face. Sometimes, the hands may tremor. In addition, some people may experience nausea and/or vomiting. In extreme cases, the muscles may twitch or spasm to a state of tetany, which produces severe, involuntary muscle contractions. Occasionally, symptoms may progress to the point of causing mental confusion or stupor and, in very rare cases, coma.

The human respiratory system.
The human respiratory system.

Diagnosis of respiratory alkalosis is made by an observation of symptoms, followed by pH testing. Analysis of fluid pH is determined by an arterial blood gas test, although a urinalysis may also be performed. These tests also help the clinician to establish whether a state of alkalosis has been induced by a respiratory disorder, or a metabolic disorder involving the kidneys instead.

Treatment is more relevant to the underlying cause of respiratory alkalosis and may involve medications to help control asthma or other breathing disorder. In an emergency scenario, the immediate symptoms would certainly be addressed, usually by giving the patient oxygen to help raise carbon dioxide levels and correct fluid pH. At home, the patient can self-treat the condition simply by breathing into a paper bag. However, if confusion, seizures, or extreme difficulty breathing should occur, a visit to the emergency room or a call to summon emergency paramedics is warranted.

The respiratory and abdominal organs.
The respiratory and abdominal organs.

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