Respiratory alkalosis is defined as an increase in pH above 7.45 due to respiratory causes. The reason is always hyperventilation, i.e. breathing too fast or too deep.
What is respiratory alkalosis?
A balanced relationship between acidic and basic substances is one of the most important regulation goals for the organism. If the pH value in the blood and in the body cells deviates up or down, the proteins denature and the metabolism quickly comes to a standstill. For what does sbs stand for, please visit biotionary.com.
In the case of respiratory alkalosis, the pH value deviates upwards, into the alkaline range. In this case, breathing is to blame.
Causes
The connections between the development of respiratory alkalosis and the resulting symptoms have meanwhile been well researched:
In many cases, hyperventilation initially has psychological causes, i.e. due to panic attacks or psychological stress situations. It mostly affects young girls going through puberty or young adults. In addition, serious diseases of the respiratory system can also lead to hyperventilation:
Inflammation of the brain, cirrhosis of the liver, blood poisoning or intoxications can irritate the respiratory center in the brain and lead to accelerated breathing. At the level of the lungs, a pulmonary embolism, pulmonary edema, pneumonia, or a severe asthma attack can lead to rapid breathing due to shortness of breath.
While in all these diseases more oxygen is to be absorbed into the bloodstream (which is hardly possible after a certain saturation), carbon dioxide is exhaled at the same time. And the latter is the problem with respiratory alkalosis: CO2 is also an important part of pH regulation. If too much of it is lost, it is replenished from acid components. This delivered CO2 is in turn exhaled – the body thus loses acid and becomes alkaline.
If you want to understand the symptoms, you have to know that protons (“acids”) and calcium ions in the bloodstream are bound to the same protein, albumin. If the blood becomes alkaline, as in the case described above, protons are released from the albumin bond in order to compensate for this lack of acid. This frees up more space for the binding of calcium, calcium ions go to the albumin, and the concentration of the calcium dissolved freely in the blood decreases.
However, the free calcium is an important stabilizer in cell membranes, especially in nerve and muscle cells. If the calcium level in the blood falls, the muscles become overexcited: the typical muscle cramps in hyperventilation tetany are the result.
Symptoms, Ailments & Signs
The symptoms of respiratory alkalosis depend on the strength and rate of carbon dioxide loss in the blood. Often the only sign observed is an increased breathing rate or increased breathing depth. But both can also occur together.
There are two forms of respiratory alkalosis. There is a chronic and an acute form. In the chronic form, compensation takes place so that there are usually no symptoms at all. However, sometimes there is a slight pressure on the chest or a lump in the throat. Acute respiratory alkalosis cannot be compensated for and is therefore characterized, depending on the extent, by dizziness, confusion, tingling and numbness, especially in the mouth area, seizures and brief loss of consciousness.
This entire complex of symptoms is also referred to as so-called hyperventilation tetany. In particularly severe cases, the calcium concentration in the blood drops. This leads to an increase in neuromuscular excitability, which becomes noticeable through cramps and pawed hands. The blood supply to the brain can sometimes be disrupted by the contraction of the blood vessels supplying the brain.
As a result, temporary unconsciousness occurs. Because respiratory alkalosis can occur as part of a variety of underlying conditions, other symptoms are often present. With successful treatment of the underlying disease, however, the respiratory alkalosis also disappears without any after-effects.
Diagnosis & History
Respiratory alkalosis is primarily manifested by muscular hyperexcitability and cramps. A typical picture is the “pawed position” of the hands, in which an involuntary flexion spasm takes place in the wrist and fingers. Discomfort in the hands and feet also occurs frequently and is also an expression of the relatively reduced calcium level.
The overall picture of psychogenic hyperventilation naturally also includes accelerated breathing and the history of psychological stress that triggered the event (typically: friend broke up, etc.). Insidiously, those affected actually experience shortness of breath, since the excitement and respiratory alkalosis also cause a subjective feeling of chest tightness.
The hyperventilating person wants to breathe even faster in a panic, although the blood is actually saturated with maximum oxygen. You have to break this vicious circle now.
Complications
Respiratory alkalosis is the result of hyperventilation, which can often occur as a complication of panic attacks and feelings of anxiety. However, the hyperventilation often causes panic attacks as part of a vicious circle, which in turn intensifies the symptoms. There is a risk of a life-threatening condition, which manifests itself due to unconsciousness, because the blood vessels that supply the brain narrow very much.
At the same time, so-called hyperventilation tetany can occur. In hyperventilation tetany, severe muscle spasms occur, which are characterized by a typical pawed position of the hands with involuntary flexion spasms. These cramps are caused by a relative lack of calcium in the blood, which is caused by the high pH value.
Since respiratory alkalosis very often has psychological causes and is often triggered by stress, the increase in hyperventilation can only be prevented by calming the affected person. However, hyperventilation is not always triggered by psychological causes. Sometimes it is a complication of an underlying condition such as liver cirrhosis, blood poisoning, encephalitis, pneumonia, pulmonary edema, pulmonary embolism, or simply a severe asthma attack.
Even then, the symptoms can worsen due to additional panic attacks. At the same time, however, there are also complications that are caused by the underlying diseases. In these cases, the hyperventilation that leads to respiratory alkalosis can only be prevented by treating the underlying disease.
When should you go to the doctor?
This disease must always be treated by a doctor. In most cases, there is no self-healing, so that the affected person is always dependent on treatment by a doctor. Self-help treatment is usually not possible either. A doctor should be consulted if the patient suffers from severe breathing difficulties. This can lead to very strong breathing, which is very deep. The patient has to take a lot of air.
A strong feeling of pressure on the chest can also indicate the disease. In some cases, the sufferer feels a lump in the throat, which can also lead to numbness or dizziness. If these symptoms persist and do not go away on their own, a doctor must be consulted. First and foremost, the general practitioner can be consulted. Further treatment is then carried out by a specialist. In acute emergencies, we recommend visiting a hospital or calling an ambulance.
Treatment & Therapy
Mind you, this is not an actual calcium deficiency that could be treated with calcium supplements, but only a complex shift in the balance in the body. The cause must therefore be attacked: breathing.
In the case of psychogenic hyperventilation, a small bag the size of a sandwich bag is held in front of the affected person’s mouth and he/she is allowed to breathe into it. The exhaled CO2 collects in the bag and is directly inhaled again in the next breath. At the same time, reassurance through coaxing is important – the hyperventilant needs to be convinced that they are not really “not getting air” but that rapid breathing is the main problem. After a few minutes, the lack of carbon dioxide will be compensated and the feeling of shortness of breath will disappear.
If the hyperventilation is based on serious illnesses, they must be treated naturally by emergency medicine. In these cases, in addition to respiratory alkalosis (same path of origin), there is often a serious lack of oxygen, which should then be the main goal of therapeutic efforts.
Prevention
In order to prevent respiratory alkalosis, it is important not to let the vicious circle of hyperventilation and subjectively felt shortness of breath develop in the first place or to break it early. Anyone who knows that they have a tendency towards these symptoms can also hold a bag in front of them for a short time when states of excitement occur. In case of doubt, however, the emergency services should always be called, who are used to dealing with such emergencies routinely and calmly and can also recognize serious illnesses.
Aftercare
The symptoms of respiratory alkalosis depend on the strength and rate of carbon dioxide loss in the blood. Often the only sign observed is an increased breathing rate or increased breathing depth. But both can also occur together. There are two forms of respiratory alkalosis.
There is a chronic and an acute form. In the chronic form, compensation takes place so that there are usually no symptoms at all. However, sometimes there is a slight pressure on the chest or a lump in the throat. Acute respiratory alkalosis cannot be compensated for and is therefore characterized, depending on the extent, by dizziness, confusion, tingling and numbness, especially in the mouth area, seizures and brief loss of consciousness.
This entire complex of symptoms is also referred to as so-called hyperventilation tetany. In particularly severe cases, the calcium concentration in the blood drops. This leads to an increase in neuromuscular excitability, which becomes noticeable through cramps and pawed hands. The blood supply to the brain can sometimes be disrupted by the contraction of the blood vessels supplying the brain.
As a result, temporary unconsciousness occurs. Because respiratory alkalosis can occur as part of a variety of underlying conditions, other symptoms are often present. With successful treatment of the underlying disease, however, the respiratory alkalosis also disappears without any after-effects.
You can do that yourself
Respiratory alkalosis can be treated quite well in normal everyday life if those affected have received detailed information from their doctor.
In the case of frequent hyperventilation, the first thing to do is to calm the panic attack. Patients can use concentration exercises to counteract the stress caused by fear and shortness of breath. Nevertheless, the relatives should keep an eye on the endangered persons and help quickly in an emergency to prevent the respiratory arrest. This also includes calling the emergency doctor if the breathing difficulties are very severe. Those affected have to take a deep breath themselves. But they can also actively participate in persuasion. Meditation and calming exercises reduce panic attacks.
It is also helpful to have a bag with you in everyday life. If necessary, those affected breathe into this bag. This compensates for the lack of carbon dioxide and the acute problem is solved. A kind of breathing training protects against shortness of breath and the panic of not being able to breathe. Anxious individuals are often prone to these symptoms. With the practical recommendations of the doctor, it is possible to counteract hyperventilation even when you are agitated.
