• Differential for Respiratory Alkalosis
  • hypoxemia
  • CNS disorder altering the respiratory center
  • Salicylate poisoning (particularly the early stage)
  • Liver dysfunction/liver failure
  • Pregnancy
  • Severe anxiety
  • Sepsis (effect of endotoxin release on the respiratory center)
  
  

  Posted 09/29/16 11:50:00 AM by Anna Krigel

• Compensatory Response to Respiratory Alkalosis
  • Acute response - lowers HCO3 by 2 meq/L for every 10 mmHg decline in PCO2
  • Chronic response (reduced PCO2 persistent for more than 3-5 days) - HCO3 level falls by 4 to 5 meq/L for every 10 mmHg reduction in PCO2
  
  

  Posted 09/29/16 01:42:31 PM by Anna Krigel

• Major consequence of alkalosis - hypokalemia
  Consider higher level of care and possible intubation for management at pH>7.55
  
  

  Posted 09/29/16 02:11:21 PM by Anna Krigel

• Acetazolamide
  • inhibits the activity of carbonic anhydrase
  • produces both NaCl and NaHCO3 loss in the urine
  • used as a diuretic in patient with volume overload and metabolic alkalosis
  
  

  Posted 09/29/16 02:17:58 PM by Anna Krigel

• For further reading...

  Integration of Acid-Base and Electrolyte Disorders (NEJM)
  
  

  Posted 09/29/16 02:24:34 PM by Anna Krigel

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