Respiratory Alkalosis - Toxicology

What is Respiratory Alkalosis?

Respiratory alkalosis is a condition characterized by a decrease in arterial carbon dioxide tension (PaCO2) and an increase in blood pH. This condition occurs when there is excessive ventilation, leading to the expulsion of too much carbon dioxide (CO2). In the context of toxicology, respiratory alkalosis can be a consequence of exposure to certain toxic substances.

How Do Toxic Agents Induce Respiratory Alkalosis?

Several toxic agents can induce respiratory alkalosis by stimulating the respiratory center in the brain, leading to hyperventilation. Some common substances include:

- Salicylates: Overdose of salicylates, such as aspirin, initially causes hyperventilation and respiratory alkalosis before leading to metabolic acidosis.
- Catecholamines: Elevated levels due to exogenous administration or endogenous release in response to stress can stimulate respiration.
- Theophylline: Overdose can lead to central nervous system stimulation and increased respiratory rate.
- Carbon monoxide: Although primarily causing hypoxia, it can also lead to hyperventilation as a compensatory mechanism.

What are the Clinical Manifestations?

The clinical manifestations of respiratory alkalosis depend on the severity and the underlying cause. Symptoms may include:

- Lightheadedness
- Numbness or tingling in the extremities
- Palpitations
- Muscle cramps or spasms
- Confusion

In severe cases, patients may experience tetany or seizures due to decreased ionized calcium levels in the blood.

How is Respiratory Alkalosis Diagnosed?

Diagnosis typically involves:

1. Arterial Blood Gas (ABG) Analysis: This is the primary diagnostic tool. It will show a high pH (>7.45) and low PaCO2 (

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