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What Causes Respiratory Alkalosis and What Are Its Treatment Options?

Respiratory Alkalosis is quite a common medical condition which has the potential to affect almost all the vital organs of the body. Respiratory Alkalosis results in numerous metabolic abnormalities with changes in the levels of calcium, potassium, and phosphate which are needed by the body to carry out various functions. This metabolic abnormality causes what is termed as lactic acidosis. The way kidneys react to the above mentioned elements also get affected by Respiratory Alkalosis.[1]

Various kinds of pulmonary conditions are believed to be responsible for the development of Respiratory Alkalosis among which hyperventilation syndrome is believed to be the primary cause. An individual with Respiratory Alkalosis will tend to have various cardiac abnormalities to include accelerated heart rate, arrhythmias, and chest pains. In the digestive tract, motility also gets affected by Respiratory Alkalosis. Vasodilation in the lungs is a common finding among people with Respiratory Alkalosis.[1]

The best way to treat Respiratory Alkalosis is by identifying the underlying cause and treating it. Hyperventilation may occur due to many reasons which range from an anxiety attack to overdose of certain medications. People who are on mechanical ventilation also are at risk for developing Respiratory Alkalosis.[1]

The classic presenting feature of Respiratory Alkalosis includes mood swings, nausea, and muscle spasms. This article highlights some of the potential causes and the treatment options for Respiratory Alkalosis.[1]

What Causes Respiratory Alkalosis?

The best way to describe Respiratory Alkalosis is breathing faster than normal. When an individual breathes exceedingly fast he tends to release more carbon dioxide than normal. This results in an imbalance in the pH scale of the body with more acid being lost due to breathing and the pH becoming alkaline. This leads to impairment of various body functions as they tend to function only when the pH balance is close to normal at baseline.[2]

Thus maintaining a pH level that is not too acidic and not too alkaline is mandatory for majority of bodily functioning. There are however some causes of Respiratory Alkalosis that are far more serious and require urgent medical treatment. The potential causes of Respiratory Alkalosis have been divided into three categories and include

Medical Condition: There are many medical conditions that can cause an individual to hyperventilate resulting in Respiratory Alkalosis. These conditions include panic and anxiety attacks, atrial flutter, liver dysfunction, pulmonary embolism, and pneumothorax.[2]

Overdose of aspirin may also lead to hyperventilation causing Respiratory Alkalosis. Pregnancy is also believed to cause hyperventilation especially in the last trimester where the female tends to breathe faster than normal due to the growing fetus resulting in Respiratory Alkalosis.[2]

Accidental Causes: At times, individuals who require ventilatory support for breathing assistance tend to have hyperventilation causing Respiratory Alkalosis as the ventilator provides excess breaths at a fast pace. This results in the individual exhaling too much of carbon dioxide which causes Respiratory Alkalosis.[2]

Deliberate Causes: At times, physician deliberately makes the individual hyperventilate. This is done by changing the settings of the ventilator. This is usually done for people with a head injury to protect the brain since it is believed that Respiratory Alkalosis may act as a protector due to the abnormal breathing pattern caused by hyperventilation.[2]

What Are The Treatment Options For Respiratory Alkalosis?

The treatment for Respiratory Alkalosis depends on what exactly is causing this condition. If it is the ventilator that is causing the individual to hyperventilate then changing the settings to bring the breathing back to normal is the way to go. In such cases, once the breathing normalizes Respiratory Alkalosis clears off quickly.[2]

In some cases, the physician may administer opioids and anxiolytics to normalize the breathing. This is done people with anxiety disorders and panic attacks. The physician may also provide extra oxygen to prevent an individual from hyperventilating. This is done for people who are on assisted breathing through a ventilator.[2]

If an abnormal heart rhythm is the root cause of Respiratory Alkalosis then medications may be prescribed to correct the disorder. Cardioversion may also be attempted to normalize the heart rate and rhythm. Since Respiratory Alkalosis does not pose a serious threat to the life of the individual and the body has its own way of normalizing the pH, physicians usually do not treat the pH imbalance too aggressively.[2]

Treating the cause of Respiratory Alkalosis is the priority so that future recurrence can be avoided. Coming to the overall prognosis, Respiratory Alkalosis is not life threatening.[2]

However, what causes the condition may be a serious condition. Thus it is important to identify the cause of Respiratory Alkalosis as quickly as possible and start treatment for it. The body by itself tries to correct the pH abnormality by preventing excretion of excess acid and increase excretion of alkaline materials from the body.[2]

In conclusion, Respiratory Alkalosis is quite a common condition seen especially in people who have a history of hyperventilation. This is seen mostly in people who have conditions like anxiety disorder or panic attacks. At times, certain heart rhythm disorders also induce hyperventilation in some people.[2]

In majority of the cases, hyperventilation is seen in people who are on ventilator for breathing assistance for some other medical condition. Respiratory Alkalosis is mainly caused due to pH imbalance with the body being more alkaline. Treatment involves normalizing the pH and treating the underlying cause.[2]

Respiratory Alkalosis in itself is not a serious illness but the cause of it may be. Thus it is important to identify the cause of Respiratory Alkalosis at the earliest and start treatment for it to prevent any untoward complication due to this condition.[2]


Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 1, 2019

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