Alkalosis

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Alkalosis
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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). Alkalosis is usually divided into the categories of respiratory alkalosis and metabolic alkalosis or a combined respiratory/metabolic alkalosis. [1]

Contents

Signs and symptoms

Metabolic alkalosis is usually accompanied by low blood potassium concentration, causing, e.g., muscular weakness, muscle pain, and muscle cramps (from disturbed function of the skeletal muscles), and muscle spasms (from disturbed function of smooth muscles).

It may also cause low blood calcium concentration. As the blood pH increases, blood transport proteins, such as albumin, become more ionized into anions. This causes the free calcium present in blood to bind more strongly with albumin. If severe, it may cause tetany.

Causes

Respiratory alkalosis is caused by hyperventilation, [2] resulting in a loss of carbon dioxide. Compensatory mechanisms for this include release of hydrogen ion from tissue buffers and excretion of bicarbonate in the kidneys, both of which lower blood pH. [3] Hyperventilation-induced alkalosis can be seen in several deadly central nervous system diseases such as strokes or Rett syndrome. [2]

Metabolic alkalosis can be caused by repeated vomiting, [2] resulting in a loss of hydrochloric acid in the stomach contents. Severe dehydration, and the consumption of alkali, [3] are other causes. It can also be caused by administration of diuretics [2] and endocrine disorders such as Cushing's syndrome. Compensatory mechanism for metabolic alkalosis involve slowed breathing by the lungs to increase serum carbon dioxide, [2] a condition leaning toward respiratory acidosis. As respiratory acidosis often accompanies the compensation for metabolic alkalosis, and vice versa, a delicate balance is created between these two conditions.

See also

Related Research Articles

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<span class="mw-page-title-main">Hypocapnia</span> State of reduced carbon dioxide in the blood

Hypocapnia, also known as hypocarbia, sometimes incorrectly called acapnia, is a state of reduced carbon dioxide in the blood. Hypocapnia usually results from deep or rapid breathing, known as hyperventilation.

<span class="mw-page-title-main">Metabolic acidosis</span> Medical condition

Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance. Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. Metabolic acidosis can lead to acidemia, which is defined as arterial blood pH that is lower than 7.35. Acidemia and acidosis are not mutually exclusive – pH and hydrogen ion concentrations also depend on the coexistence of other acid-base disorders; therefore, pH levels in people with metabolic acidosis can range from low to high.

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<span class="mw-page-title-main">Respiratory alkalosis</span> Medical condition

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 primary disturbance of acid–base homeostasis.

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<span class="mw-page-title-main">Metabolic alkalosis</span> Medical condition

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 ion concentration, 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.

In physiology, base excess and base deficit refer to an excess or deficit, respectively, in the amount of base present in the blood. The value is usually reported as a concentration in units of mEq/L (mmol/L), with positive numbers indicating an excess of base and negative a deficit. A typical reference range for base excess is −2 to +2 mEq/L.

Acid–base homeostasis is the homeostatic regulation of the pH of the body's extracellular fluid (ECF). The proper balance between the acids and bases in the ECF is crucial for the normal physiology of the body—and for cellular metabolism. The pH of the intracellular fluid and the extracellular fluid need to be maintained at a constant level.

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<span class="mw-page-title-main">Tetany</span> Medical condition, exhibiting involuntary contraction of muscles

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<span class="mw-page-title-main">Respiratory compensation</span> Medical condition

Respiratory compensation is the modulation by the brainstem respiratory centers, which involves altering alveolar ventilation to try and bring the plasma pH back to its normal value (7.4) in order to keep the acid-base balance in the body. It usually occurs within minutes to hours and is much faster than renal compensation, but has less ability to restore normal values.

pCO<sub>2</sub> Partial pressure of carbon dioxide, often used in reference to blood

pCO2, pCO2, or is the partial pressure of carbon dioxide (CO2), often used in reference to blood but also used in meteorology, climate science, oceanography, and limnology to describe the fractional pressure of CO2 as a function of its concentration in gas or dissolved phases. The units of pCO2 are mmHg, atm, torr, Pa, or any other standard unit of atmospheric pressure. The pCO2 of Earth's atmosphere has risen from approximately 280 ppm (parts-per-million) to a mean 2019 value of 409.8 ppm as a result of anthropogenic release of carbon dioxide from fossil fuel burning. This is the highest atmospheric concentration to have existed on Earth for at least the last 800,000 years.

<span class="mw-page-title-main">Acid–base disorder</span> Medical condition

Acid–base imbalance is an abnormality of the human body's normal balance of acids and bases that causes the plasma pH to deviate out of the normal range. In the fetus, the normal range differs based on which umbilical vessel is sampled. It can exist in varying levels of severity, some life-threatening.

References

  1. Mosby's Paramedic Textbook – Mick J. Sanders
  2. 1 2 3 4 5 Yee AH, Rabinstein AA (February 2010). "Neurologic presentations of acid-base imbalance, electrolyte abnormalities, and endocrine emergencies". Neurol Clin. 28 (1): 1–16. doi:10.1016/j.ncl.2009.09.002. PMID   19932372.
  3. 1 2 Norman G. Levinsky (1987). Eugene Braunwald; et al. (eds.). Harrison's Principles of Internal Medicine (11 ed.). pp. 212–214. ISBN   0-07-100134-4.