What Is Respiratory Alkalosis?
Respiratory alkalosis refers to the primary decrease in plasma H 2 CO 3 concentration or PaCO 2 caused by excessive pulmonary ventilation, resulting in an increase in pH (> 7.45). Divided into acute and chronic categories according to the incidence. For every 10mmHg (1.3kPa) decrease in PaCO 2 in acute patients, HC0 3 [sup]-[/ sup] decreases by about 2mmol / L; in chronic patients, HCO 3 [sup]-[/ sup] decreases by 4 5mmol / L.
Basic Information
- English name
- respiratoryalkalosis
- Visiting department
- Endocrinology
- Common causes
- Hyperventilation, abnormal metabolic processes, hypoxic hypoxia, central nervous system disorders, salicylic acidosis, etc.
- Common symptoms
- Numbness in hands, feet, face, especially around the mouth, and acupuncture-like sensations, chest tightness, chest pain, dizziness, fear, and even convulsions in limbs, shallow and slow breathing
Causes of respiratory alkalosis
- 1. Hyperventilation
- Common causes of respiratory alkalosis. In severe cases, dizziness, paresthesia, and occasional convulsions can occur. Common in patients with rickets.
- 2. Abnormal metabolic processes
- During hyperthyroidism and fever, ventilation can significantly increase the amount of CO 2 that should be expelled. Can cause respiratory alkalosis, but is generally not severe. Hyperventilation at this time may be caused by increased pulmonary blood flow through reflex responses.
- 3. Hypoxic hypoxia
- Hyperventilation during hypoxic hypoxia is a compensation for hypoxia, but at the same time can cause excessive exhaust of CO 2 and cause respiratory alkalosis. Common in people who enter the plateau, mountains, or altitudes; patients with thoracic and pulmonary lesions such as pneumonia, pulmonary embolism, pneumothorax, pulmonary congestion, etc., which cause stimulated afferent nerves in the thorax, pulmonary blood vessels, or lung tissues to increase reflex ventilation; in addition, some In patients with congenital heart disease, hypotonic hypoxemia due to increased right-to-left shunting can also occur with hyperventilation.
- 4. Central nervous system disorders
- Patients with encephalitis, meningitis, brain tumors, cerebrovascular accidents, and craniocerebral injury are stimulated and excited, and hyperventilation occurs.
- 5. Salicylic acidosis
- Salicylic acid can directly stimulate the respiratory center to increase its excitability and sensitivity to normal stimuli. As a result, hyperventilation occurs.
- 6. Gram-negative bacillus sepsis
- Patients with gram-negative bacilli who enter the bloodstream and reproduce can have significant hyperventilation before temperature and blood pressure have not changed. Pco 2 has as low as 17mmHg. This change is very helpful for diagnosis.
- 7. Artificial respiration.
- 8. Cirrhosis
- Hyperventilation may occur in patients with cirrhosis who have ascites and elevated blood NH 3 . It may be caused by the stimulating effect of NH 3 on the respiratory center.
- 9. Metabolic acidosis
- Suddenly corrected, such as the use of NaHCO 3 to correct metabolic acidosis, the extracellular fluid [HCO 3- ] concentration quickly rose to normal, but passed through the blood-brain plasma barrier very slowly, at this time the brain is still metabolic acidosis, so hyperventilation is still continue living.
- 10. pregnancy
- There is a moderate increase in ventilation during pregnancy. It is currently believed that progesterone stimulates the respiratory center. Some synthetic progesterone preparations also have this effect. Ketoacidosis can occur due to vomiting and insufficient diet during pregnancy, and respiratory alkalosis can occur after pregnancy reaction, sometimes causing hand-foot convulsions.
Clinical manifestations of respiratory alkalosis
- 1. Numbness in hands, feet, face, especially around the mouth, and acupuncture-like sensations.
- 2. Chest tightness, chest pain, dizziness, fear, and even twitching of the limbs.
- 3. Breathe shallowly and slowly.
- 4. Respiratory alkalosis is called acute respiratory alkalosis within 6 hours when the kidney still shows obvious compensatory function. 6 to 18 hours after the occurrence of respiratory alkalosis, when the kidneys have shown compensatory function, it is called persistent respiratory alkalosis, or chronic respiratory alkalosis.
Respiratory alkalosis test
- 1. Blood gas analysis and detection.
- 2. Electrolyte sodium, potassium, calcium, chlorine and magnesium detection.
- 3. Liver and kidney function tests.
- According to the condition and clinical symptoms, ECG, B-ultrasound and X-ray examination were selected.
Diagnosis of respiratory alkalosis
- A diagnosis of acute or chronic respiratory alkalosis can be derived from medical history, physical signs, and blood gas analysis.
Respiratory alkalosis treatment
- 1. Actively treat the primary disease, and gradually recover in the process of treating the primary disease.
- 2. For hyperventilated patients, inhale oxygen containing 5% CO 2 .
- 3. For snoring and neurotic patients or those who are nervous and irritable, a larger paper bag can be placed on the nose and mouth for rebreathing to increase arterial blood PCO 2 , stimulate the respiratory center, and introduce normal breathing.
- 4. When sputum is sputum after chest and abdomen surgery, because of fear of pain, do not dare to inhale deeply, causing the exhalation to be longer than inhalation. When respiratory alkalosis occurs, you can also use paper bag rebreathing method, or take a temporary forced air closure Breath can be directed to normal.
- 5. Patients with tetany can give proper calcium supplement intravenously, and inject 10% calcium gluconate slowly.