Respiratory alkalosis is a systemic acid-base disorder characterised by a primar y reduction in arterial partial pressure of carbon dioxide (PaCO2), which

produc es an elevation in pH, and consequent decrease in bicarbonate (HCO3-) concentrat ion, as buffering mechanisms. [1] It may occur as a simple primary disorder, a s ole respiratory abnormality in which a decrease in PaCO2 results from excess alv eolar CO2 excretion relative to CO2 production. Respiratory alkalosis may also o ccur as compensation for an underlying process, such as metabolic acidosis, or a s a separate component of a mixed acid-base disorder, in which case the PaCO2, H CO3-, and pH are determined by the combined effects of the underlying acid-base disorders. [2] Respiratory alkalosis can be classified into three categories: 1) as a component of disease processes, 2) accidentally induced, and 3) deliberate ly induced (therapeutic). [3] Accidental respiratory alkalosis develops as a con sequence of inappropriate settings of mechanical ventilation, or associated with extracorporeal membrane oxygenation. [3] Therapeutic respiratory alkalosis or h ypocapnia has been applied to temporarily treat intracranial hypertension or neo natal pulmonary artery hypertension