[Acid-Base imbalances] Respiratory Alkalosis / 호흡성 알칼리증

1. Lab values

Blood pH increased (>7.45)

Carbon dioxide levels increase (<35)

To compensate for this the Kidneys start to excrete bicarbonate (HCO3) to hopefully decrease the blood's pH back to normal ... so HCO3 becomes <22.

 

2. Causes of Respiratory Alkalosis: remember tachypnea (fast breathing leads to "hyperventilation" which leads to respiratory alkalosis)

(T) Temperature increase (Fever) due to increased metabolic needs of the body which cuases the respiratory center (medulla and pons) to try to compensate by making the respiratory rate increased... hence exhaling too much carbon dioxide (CO2)

 

(A) Aspirin tocixity (salicylate toxicity): too much leads to hyperventilation due to the stimulation of the respiratory center and fever

(C) Controlled ventilation excessive (mechanical ventilation too fast): hyperventilates the paitent with too much oxygen and depletes carbon dioxide

(H) Hyperventilation (excesive respirations) expelling too much carbon dioxide

(Y) hYsteria (anxiety) leads to rapid breathing and expelling of carbon dioxide

(P) Pain.. rapid breathing (blowing off too much carbon dioxide)

(N) Neurological demage: inflammation of the brain

(E) Embolism in lungs (clot), Edema in lungs

(A) Ascending in altitude: low oxygen levels causes the body to hyperventilate

 

3. S+S of Respiratory Alkalosis

 i) **classic assessment Sign is fast respiratory rate (normal for adult is 12-20) TACHYPNEA (>20bpm)

 ii) Neuro changes: anxiety, fear, dizzy, seizures

 iii) increase heart rate

 iv) Tetany, dysrhythmias, muscle cramps, positive Chvostek's sign due to hypocalcemia and hypokalemia

 

4. NRS Action -> REST (Find cause and correct it. We want the patient to decrease breathing rate and REST!

(R) Rebreather mask or paper bag to slow down breathing

(E) Electrolytes monitored: hypokalemia and hypocalcemia

(S) Sedatives or anti-anxiety meds to relieve anxiety and decrease hyperventilation

(T) Teach relaxation and stress de-escalation techniques.

 

5. 틱택토 매소드

ACID. <-normal-> Base

PH <-7.35~7.45-> PH

PaCO2<-45~35->PaCO2

HCO3<-22~26->HCO3