This document discusses alkalosis, specifically respiratory alkalosis and metabolic alkalosis. Respiratory alkalosis occurs when increased respiration elevates blood pH beyond normal levels due to reduced carbon dioxide levels. Causes include stress, pulmonary disorders, and hyperventilation. Metabolic alkalosis results from decreased hydrogen ion concentration leading to increased bicarbonate levels. Compensations include lung retention of carbon dioxide and renal excretion of bicarbonate. Treatment involves addressing underlying causes and administering chloride-rich fluids in some cases of metabolic alkalosis.

1. ALKALOSIS
• BY: Syed Hassnain Shah
• TO: Mam Katerina

2. Alkalosis is the result of a process
reducing hydrogen
ion concentration of arterial blood
plasma (alkalemia).
In contrast to acidemia(serum pH
7.35 or lower)
alkalemia occurs when the serum
pH is higher than normal (7.45 or
higher).

3. TYPES OF ALLALOSIS
Respiratory alkalosis
Metabolic alkalosis

4. RESPIRATORY ALKALOSIS
 Respiratory alkalosis is a medical condition
in which increased respiration elevates the
blood pH beyond the normal range (7.35–
7.45) with a concurrent reduction in arterial
levels of carbon dioxide.
 This condition is one of the four basic
categories of disruption of acid–base
homeostasis.

5. Signs and symptoms
Signs and symptoms of respiratory
alkalosis are as follows:[4]
Palpitation
Tetany
Convulsion
Sweating

6. CAUSES
 Respiratory alkalosis may be produced as a result of
the following causes:
 Stress
 Pulmonary disorder
 Thermal insult
 High altitude areas
 Salicylate poisoning (aspirin overdose)
 Fever
 Hyperventilation (due to heart disorder or other,
including improper mechanical ventilation)
 Vocal cord paralysis (compensation for loss of vocal
volume results in over-breathing/breathlessness).
 Liver disease

7. MECHANISM
 The mechanism of respiratory alkalosis generally occurs
when some stimulus makes a person hyperventilate.
 The increased breathing produces
increased alveolarrespiration.
 Expelling CO2 from the circulation. This alters the
dynamic chemical equilibriumof carbon dioxide in the
circulatory system.
 Circulating hydrogen ions and bicarbonate are shifted
through the carbonic acid (H2CO3) intermediate to make
more CO2
 This causes decreased circulating hydrogen ion
concentration, and increased pH(alkalosis).

8. TREATMENT
 Respiratory alkalosis is very rarely life-
threatening, though pH level should not be
7.5 or greater. The aim in treatment is to
detect the underlying cause. When PaCO2
is adjusted rapidly in individuals with chronic
respiratory alkalosis, metabolic acidosis may
occur.[2] If the individual is on a mechanical
ventilator then preventing hyperventilation is
done via monitoringABG levels.

9. METABOLIC ALKALOSIS
 Metabolic alkalosis is a metabolic condition in which
the pH of tissue is elevated beyond the normal range
(7.35–7.45). This is the result of decreased hydrogen
ionconcentration, leading to increased bicarbonate, or
alternatively a direct result of
increased bicarbonate concentrations. The condition
typically cannot last long if the kidneys are functioning
properly.

10. SIGNS AND SYMPTOMS
 Mild cases of metabolic alkalosis often causes no
symptoms. Typical manifestations of moderate to
severe metabolic alkalosis include abnormal
sensations, neuromuscular
irritability, tetany, abnormal heart rhythms(usually
due to accompanying electrolyteabnormalities
such as low levels of potassium in the
blood), coma, seizures, and temporary waxing and
waning confusion.

11. COMPENSATIONS
 There are two types of compensations :
 Lung compensation
 Renal compensation

12. LUNG COMPENSATION
 Compensation for metabolic alkalosis occurs
mainly in the lungs, which retain carbon
dioxide (CO2) through slower breathing,
or hypoventilation (respiratory
compensation). CO2 is then consumed
toward the formation of the carbonic
acid intermediate, thus decreasing pH.

13. RENAL COMPENSATION
 Renal compensation for metabolic alkalosis,
less effective than respiratory
compensation, consists of increased
excretion of HCO3−(bicarbonate), as the
filtered load of HCO3−exceeds the ability of
the renal tubule to reabsorb it.

14. TREATMENT
To effectively treat metabolic alkalosis, the
underlying cause(s) must be corrected. A
trial of intravenous chloride-rich fluid is
warranted if there is a high index of
suspicion for chloride-responsive metabolic
alkalosis caused by loss of gastrointestinal
fluid (e.g., due to vomiting).