Alkalosis

Alkalosis
SpecialtyEndocrinology 
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Alkalosis is the result of a process reducing hydrogen ion concentration of arterial blood plasma (alkalemia). In contrast to acidemia (serum pH 7.35 or lower), alkalemia occurs when the serum pH is higher than normal (7.45 or higher). Alkalosis is usually divided into the categories of respiratory alkalosis and metabolic alkalosis or a combined respiratory/metabolic alkalosis.[1]

Signs and symptoms

Metabolic alkalosis is usually accompanied by low blood potassium concentration, causing, e.g., muscular weakness, muscle pain, and muscle cramps (from disturbed function of the skeletal muscles), and muscle spasms (from disturbed function of smooth muscles).

It may also cause low blood calcium concentration. As the blood pH increases, blood transport proteins, such as albumin, become more ionized into anions. This causes the free calcium present in blood to bind more strongly with albumin. If severe, it may cause tetany.

Causes

Respiratory alkalosis is caused by hyperventilation,[2] resulting in a loss of carbon dioxide. Compensatory mechanisms for this include release of hydrogen ion from tissue buffers and excretion of bicarbonate in the kidneys, both of which lower blood pH.[3] Hyperventilation-induced alkalosis can be seen in several deadly central nervous system diseases such as strokes or Rett syndrome.[2]

Metabolic alkalosis can be caused by repeated vomiting,[2] resulting in a loss of hydrochloric acid in the stomach contents. Severe dehydration, and the consumption of alkali,[3] are other causes. It can also be caused by administration of diuretics[2] and endocrine disorders such as Cushing's syndrome. Compensatory mechanism for metabolic alkalosis involve slowed breathing by the lungs to increase serum carbon dioxide,[2] a condition leaning toward respiratory acidosis. As respiratory acidosis often accompanies the compensation for metabolic alkalosis, and vice versa, a delicate balance is created between these two conditions.

See also

References

  1. ↑ Mosby's Paramedic Textbook – Mick J. Sanders
  2. 1 2 3 4 5 Yee AH, Rabinstein AA (February 2010). "Neurologic presentations of acid-base imbalance, electrolyte abnormalities, and endocrine emergencies". Neurol Clin. 28 (1): 1–16. doi:10.1016/j.ncl.2009.09.002. PMID 19932372.
  3. 1 2 Norman G. Levinsky (1987). Eugene Braunwald; et al. (eds.). Harrison's Principles of Internal Medicine (11 ed.). pp. 212–214. ISBN 0-07-100134-4.
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