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American Journal of Kidney Diseases :... Sep 2023The respiratory system plays an integral part in maintaining acid-base homeostasis. Normal ventilation participates in the maintenance of an open buffer system, allowing... (Review)
Review
The respiratory system plays an integral part in maintaining acid-base homeostasis. Normal ventilation participates in the maintenance of an open buffer system, allowing for excretion of CO produced from the interaction of nonvolatile acids and bicarbonate. Quantitatively of much greater importance is the excretion of CO derived from volatile acids produced from the complete oxidation of fat and carbohydrate. A primary increase in CO tension of body fluids is the cause of respiratory acidosis and develops most commonly from one or more of the following: (1) disorders affecting gas exchange across the pulmonary capillary, (2) disorders of the chest wall and the respiratory muscles, and/or (3) inhibition of the medullary respiratory center. Respiratory alkalosis or primary hypocapnia is most commonly caused by disorders that increase alveolar ventilation and is defined by an arterial partial pressure of CO <35 mm Hg with subsequent alkalization of body fluids. Both disorders can lead to life-threatening complications, making it of paramount importance for the clinician to have a thorough understanding of the cause and treatment of these acid-base disturbances.
Topics: Humans; Acidosis, Respiratory; Alkalosis, Respiratory; Carbon Dioxide; Hypocapnia; Bicarbonates; Alkalosis; Hydrogen-Ion Concentration; Acid-Base Equilibrium
PubMed: 37341662
DOI: 10.1053/j.ajkd.2023.02.004 -
Respiratory Care Apr 2001Respiratory alkalosis is an extremely common and complicated problem affecting virtually every organ system in the body. This article reviews the various facets of this... (Review)
Review
Respiratory alkalosis is an extremely common and complicated problem affecting virtually every organ system in the body. This article reviews the various facets of this interesting problem. Respiratory alkalosis produces multiple metabolic abnormalities, from changes in potassium, phosphate, and calcium, to the development of a mild lactic acidosis. Renal handling of the above ions is also affected. The etiologies may be related to pulmonary or extrapulmonary disorders. Hyperventilation syndrome is a common etiology of respiratory alkalosis in the emergency department setting and is a diagnosis by exclusion. There are many cardiac effects of respiratory alkalosis, such as tachycardia, ventricular and atrial arrhythmias, and ischemic and nonischemic chest pain. In the lungs, vasodilation occurs, and in the gastrointestinal system there are changes in perfusion, motility, and electrolyte handling. Therapeutically, respiratory alkalosis is used for treatment of elevated intracranial pressure. Correction of a respiratory alkalosis is best performed by correcting the underlying etiology.
Topics: Alkalosis, Respiratory; Homeostasis; Humans; Hyperventilation; Hypoxia; Lung Diseases; Oxygen; Respiration, Artificial
PubMed: 11262557
DOI: No ID Found -
The Veterinary Clinics of North... Mar 2017Respiratory alkalosis, or primary hypocapnia, occurs when alveolar ventilation exceeds that required to eliminate the carbon dioxide produced by tissues. Concurrent... (Review)
Review
Respiratory alkalosis, or primary hypocapnia, occurs when alveolar ventilation exceeds that required to eliminate the carbon dioxide produced by tissues. Concurrent decreases in Paco, increases in pH, and compensatory decreases in blood HCO levels are associated with respiratory alkalosis. Respiratory alkalosis can be acute or chronic, with metabolic compensation initially consisting of cellular uptake of HCO and buffering by intracellular phosphates and proteins. Chronic respiratory alkalosis results in longer-lasting decreases in renal reabsorption of HCO; the arterial pH can approach near-normal values.
Topics: Acid-Base Equilibrium; Acid-Base Imbalance; Algorithms; Alkalosis, Respiratory; Animals
PubMed: 27939863
DOI: 10.1016/j.cvsm.2016.10.005 -
ELife Jan 2022Hyperventilation reliably provokes seizures in patients diagnosed with absence epilepsy. Despite this predictable patient response, the mechanisms that enable...
Hyperventilation reliably provokes seizures in patients diagnosed with absence epilepsy. Despite this predictable patient response, the mechanisms that enable hyperventilation to powerfully activate absence seizure-generating circuits remain entirely unknown. By utilizing gas exchange manipulations and optogenetics in the WAG/Rij rat, an established rodent model of absence epilepsy, we demonstrate that absence seizures are highly sensitive to arterial carbon dioxide, suggesting that seizure-generating circuits are sensitive to pH. Moreover, hyperventilation consistently activated neurons within the intralaminar nuclei of the thalamus, a structure implicated in seizure generation. We show that intralaminar thalamus also contains pH-sensitive neurons. Collectively, these observations suggest that hyperventilation activates pH-sensitive neurons of the intralaminar nuclei to provoke absence seizures.
Topics: Alkalosis, Respiratory; Animals; Carbon Dioxide; Hydrogen-Ion Concentration; Hypoxia; Intralaminar Thalamic Nuclei; Male; Neurons; Rats; Seizures
PubMed: 34982032
DOI: 10.7554/eLife.72898 -
Age and Ageing Oct 2020
Review
Topics: Alkalosis, Respiratory; Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Pandemics; Phosphates; Pneumonia, Viral; SARS-CoV-2
PubMed: 32725143
DOI: 10.1093/ageing/afaa176 -
Indian Journal of Pediatrics Oct 2020
Topics: Alkalosis, Respiratory; Humans; Hydrogen-Ion Concentration; Neurodegenerative Diseases
PubMed: 32328887
DOI: 10.1007/s12098-020-03288-x -
Annals of the New York Academy of... Apr 1957
Topics: Alkalosis; Alkalosis, Respiratory; Humans
PubMed: 13488243
DOI: 10.1111/j.1749-6632.1957.tb40781.x -
Nutrition in Clinical Practice :... Oct 2022An understanding of acid-base physiology is necessary for clinicians to recognize and correct problems that may negatively affect provision of nutrition support and drug... (Review)
Review
An understanding of acid-base physiology is necessary for clinicians to recognize and correct problems that may negatively affect provision of nutrition support and drug therapy. An overview of acid-base physiology, the different acid-base disorders encountered in practice, a stepwise approach to evaluate arterial blood gases, and other key diagnostic tools helpful in formulating a safe and effective medical and nutrition plan are covered in this acid-base primer. Case scenarios are also provided for the application of principles and the development of clinical skills.
Topics: Acid-Base Equilibrium; Acid-Base Imbalance; Acidosis; Alkalosis; Alkalosis, Respiratory; Blood Gas Analysis; Humans; Hydrogen-Ion Concentration
PubMed: 35752932
DOI: 10.1002/ncp.10881 -
The Veterinary Clinics of North... May 2008This article serves as a quick reference for respiratory alkalosis. Guidelines for analysis and causes, signs, and a stepwise approach are presented. (Review)
Review
This article serves as a quick reference for respiratory alkalosis. Guidelines for analysis and causes, signs, and a stepwise approach are presented.
Topics: Alkalosis, Respiratory; Animals; Bicarbonates; Blood Gas Analysis; Carbon Dioxide; Hydrogen-Ion Concentration; Partial Pressure; Reference Values
PubMed: 18402862
DOI: 10.1016/j.cvsm.2008.01.017 -
Acute Care 1986
Review
Topics: Alkalosis, Respiratory; Chemoreceptor Cells; Hemodynamics; Humans; Hyperventilation
PubMed: 3324611
DOI: No ID Found