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439
S. Faubel and J. Topf16 Respiratory Alkalosis
16
16 Respiratory Alkalosis
440
The Fluid, Electrolyte and Acid-Base Companion
Respiratory alkalosis is characterized by a decreased P
CO
2
and an increasedpH. After buffering and renal compensation, the bicarbonate is decreased. A decrease in P
CO
2
, known as hypocapnia, is always the result of hyperventi-lation.Carbon dioxide
is a waste product of metabolism which is eliminated bythe lungs. With appropriate respiration, P
CO
2
is normally kept within a nar-row range (40
±
4 mmHg). Respiratory alkalosis occurs when the lungs elimi-nate more carbon dioxide than is produced by metabolism. Ventilation aboveand beyond what is necessary is known as hyperventilation.
The study of respiratory alkalosis is the study of hyperventilation
.
Introduction
Respiratory alkalosis is due to hyperventilation.
pH
∝
HCO
3 –
CO
2
pH
∝
HCO
3 –
CO
2
pH
∝
HCO
3 –
CO
2
pH
∝
HCO
3 –
CO
2
METABOLIC
ALKALOSISRESPIRATORY
ALKALOSISRESPIRATORY
ACIDOSISMETABOLIC
ACIDOSIS
Respiratory alkalosis is characterized by a decrease in ______which causes an increase in ______.Carbon dioxide is a waste product of _________ and a relativelyconsistent amount is produced each day. A primary decrease in P
CO
2
is always due to ______________.P
CO
2
pHmetabolismhyperventilation
441
S. Faubel and J. Topf16 Respiratory Alkalosis
In respiratory alkalosis, the decrease in carbon dioxide is always due to
hyper
ventilation caused by altered sensing and signaling. This differs fromrespiratory acidosis where
hypo
ventilation can be due to defects in any of the four steps of respiration.The factors which affect the respiratory control center and cause hyper-ventilation will be introduced on the next page.
Introduction
Hyperventilation is due to altered sensing andsignaling.
There are _______ fundamental steps of respiration•sensing and _________•__________ and motion•free _____•gas __________Respiratory _________ can be due to a defect in any one of the steps of respiration, while respiratory __________is onlydue to alterations in ________ and signaling.foursignalingmusclesflowexchangeacidosisalkalosissensing
The only cause of hyperventilation which is not due to altered sensing and signaling isoverventilation on a mechanical ventilator.
CO
2
CO
2
CO
2
O
2
O
2
O
2
O
2
O
2
O
2
Muscles and motion
The muscles of respiration expand the chest whichlowers intrathoracic pressure and draws air intothe lungs.
Sensing and signaling
The respiratory control center in the medulla re-sponds to changes in CO
2
, O
2
and pH by sendingsignals via nerves to the muscles of respiration.
Free flow
A patent airway is necessary for air to flow intothe alveoli.
Gas exchange
Exchange of CO
2
and O
2
occurs in the alveoli. Ox-ygen enters the blood and CO
2
enters the alveoli.
; ; ; ;
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