respiratory alkalosis Respiratory alkalosis refers to a condition where a patient experiences decreased arterial carbon dioxide pressure (PaCO2) and increased pH in the blood due to excessive lung ventilation. Patients often exhibit symptoms related to underlying pulmonary hyperventilation, commonly accompanied by rapid breathing, increased heart rate, as well as numbness and tingling in the extremities and around the mouth.

Respiratory alkalosis refers to a condition in which excessive lung ventilation leads to a decrease in the arterial carbon dioxide partial pressure (PaCO2) and an increase in pH in the patient's blood. Patients often exhibit symptoms related to excessive lung ventilation-related underlying diseases, often accompanied by rapid breathing, increased heart rate, tingling and numbness in the extremities and around the mouth, among other symptoms.

Respiratory alkalosis can be classified into two types based on the onset time: acute respiratory alkalosis and chronic respiratory alkalosis.

Acute respiratory alkalosis

Generally, it refers to a rapid decrease in PaCO2 within 24 hours, leading to an increase in pH. This is commonly seen with improper use of mechanical ventilators, high fever, and hypoxemia.

Chronic respiratory alkalosis

This refers to a prolonged decrease in PCO2 for more than 24 hours, leading to an increase in pH. It is commonly associated with chronic brain diseases, pulmonary disorders, hypoxia, and elevated blood ammonia levels stimulating the respiratory center.

Central nervous system diseases

During hysterical episodes, hyperventilation can lead to respiratory alkalosis.

Conditions such as cerebrovascular disorders, encephalitis, head trauma, or brain tumors can directly stimulate the respiratory center, causing hyperventilation.

Certain drugs such as salicylic acid and ammonium salts can directly stimulate the respiratory center, leading to hyperventilation and respiratory alkalosis.

Improper use of mechanical ventilation

Excessive tidal volume or rapid ventilation rates can cause severe respiratory alkalosis.

Metabolic hyperactivity

High fever, hyperthyroidism, trauma, pain, and Gram-negative septicemia can stimulate the respiratory center, leading to hyperventilation and respiratory alkalosis.

Hypoxemia

Low oxygen partial pressure due to various reasons such as high-altitude environments, thoracic disorders, asthma, pneumonia, pulmonary embolism, and acute respiratory distress syndrome can stimulate respiratory drive, leading to increased CO2 excretion and respiratory alkalosis.

Rapid breathing and increased heart rate

Most patients exhibit rapid breathing and an increased heart rate, leading to hyperventilation and respiratory alkalosis. Acute respiratory alkalosis in critically ill patients often indicates a poor prognosis or the potential development of acute respiratory distress syndrome.

Increased neuromuscular excitability

Patients with respiratory alkalosis often experience hypocalcemia, leading to increased neuromuscular excitability, with symptoms such as tingling and numbness in the hands, feet, and around the mouth, muscle tremors, and tetany.

Neurological dysfunction

Patients may experience dizziness, lethargy, and impaired consciousness due to the direct damaging effects of alkalosis on brain function, as well as cerebral vasoconstriction caused by hypocapnia leading to reduced cerebral blood flow.

Dietary recommendations:

Consumption of moderate amounts of acidic foods such as cream, cheese, bread, and egg yolks can help alleviate the degree of alkalosis in the patient's body.

Moderate consumption of protein-rich foods such as chicken, beef, and pork can enhance the patient's immune system. Additionally, most meats are acidic, which can alleviate the degree of alkalosis in the patient's body.

Dietary restrictions:

During alkalosis, it is advisable to consume fewer alkaline foods such as vegetables and fruits.

Avoid spicy and irritating foods such as peppers, peppercorns, and Sichuan peppercorns, as these foods can stimulate the respiratory center, leading to hyperventilation.

Exercise

For patients with mild alkalosis and overall good condition, moderate physical exercise is recommended to promote blood circulation and tissue oxygenation, preventing excessive ventilation due to hypoxia.

Lifestyle

Patients should ensure an adequate amount of sleep every day, maintain a regular sleep schedule, and preserve abundant energy in the body.

Emotional well-being

Patients should strive to maintain a relaxed and pleasant mood daily, as this has a positive effect on the treatment and recovery of the disease.

It is important to maintain a balanced diet with the inclusion of acidic foods, and to maintain good mental health and adequate sleep.

For patients with severe respiratory system diseases, timely oxygen therapy should be administered to effectively prevent the occurrence of respiratory alkalosis.

Correct use of a ventilator, adjusting tidal volume and respiratory rate according to the patient's individual condition can prevent the development of respiratory alkalosis.