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Respiratory alkalosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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This is characterised by reduced PaCO2, normal or slightly reduced serum bicarbonate, and a raised pH.

A respiratory alkalosis may be pure or it may be complicated by a metabolic derangement (i.e. a mixed alkalosis). Measurement of the serum bicarbonate permits definitive diagnosis:

  • acute respiratory alkalosis:
    • serum bicarbonate decreases by 2 mM for every 10 mmHg (or 1.33kPa) decrease in PaCO2

  • chronic respiratory alkalosis:
    • serum bicarbonate decreases 5 mM for every 10 mmHg decrease in PaCO2

  • if the serum bicarbonate is higher than expected then the condition is likely to be a mixed metabolic alkalosis and respiratory alkalosis

  • if the serum bicarbonate is lower than expected then the condition is likely to be a mixed metabolic acidosis and respiratory alkalosis

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