Respiratory alkalosis is a medical condition characterized by decreased serum carbon dioxide levels. Since the lungs are involved, which are one of two organs that regulate the acid-base pH relationship in the body, respiratory alkalosis is also marked by body fluids becoming too alkaline. Although respiratory alkalosis is rarely life-threatening, it can sometimes lead to serious complications, such as seizures, cardiac arrhythmias, or loss of consciousness.
The mechanism behind respiratory alkalosis is quite simple. First, breathing very quickly brings more oxygen to the lungs than normal. Normally, the oxygen would be exchanged and exhaled as carbon dioxide. However, when breathing becomes difficult and the person struggles to get more air by breathing faster, this exchange does not occur at the proper speed. This is what leads to abnormally low levels of carbon dioxide in the blood, which in turn causes the body's pH to become too alkaline.
Several things can cause respiratory alkalosis. The main cause is hyperventilation, which can be due to various medical problems. For example, 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 collectively labeled as chronic obstructive pulmonary disease (COPD). However, hyperventilation can also be caused by severe anxiety, panic attacks, experiencing fearful situations or phobias, or even in response to fever.
The most common symptoms of respiratory alkalosis are dizziness and a tingling sensation in the fingers, toes, or face. Sometimes the hands may shake. Additionally, some people may experience nausea and/or vomiting. In extreme cases, the muscles can contract or spasm to a state of tetany, resulting in severe and involuntary muscle contractions. Occasionally, symptoms may progress to the point of mental confusion or stupor and, in very rare cases, coma.
The diagnosis of respiratory alkalosis is made by observation of symptoms, followed by a pH test. The analysis of the pH of the fluid is determined by an arterial blood gas test, although a urinalysis can also be performed. These tests also help the doctor establish whether a state of alkalosis has been induced by a respiratory disorder or a metabolic disorder that affects the kidneys.
Treatment is most relevant to the underlying cause of respiratory alkalosis and may include medications to help control asthma or another breathing disorder. In an emergency setting, immediate symptoms would typically be addressed 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 occurs, a visit to the emergency room or a call to summon emergency paramedics is warranted.