Pediatric Respiratory Alkalosis Treatment & Management
- Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: Michael R Bye, MD more...
Care in patients with respiratory alkalosis is primarily directed to the underlying etiology.
Respiratory alkalosis is rarely life threatening. Direct measures to correct it are usually unnecessary and often may not work unless the underlying cause is treated.
Respiratory alkalosis encountered during mechanical ventilation may be corrected by reducing the rate or the tidal volume or using sedation and paralysis (if it is caused by patient-triggered ventilator breaths).
Patients with hyperventilation syndrome may be immediately relieved by rebreathing into a small-volume paper bag; then, the physician should address treating the patient's psychological stress.
Johnson RA. Respiratory alkalosis: a quick reference. Vet Clin North Am Small Anim Pract. 2008 May. 38(3):427-30, vii. [Medline].
Ueda Y, Aizawa M, Takahashi A, Fujii M, Isaka Y. Exaggerated compensatory response to acute respiratory alkalosis in panic disorder is induced by increased lactic acid production. Nephrol Dial Transplant. 2009 Mar. 24(3):825-8. [Medline].
Yang XF, Shi XY, Ju J, Zhang WN, Liu YJ, Li XY, et al. 5% CO2 inhalation suppresses hyperventilation-induced absence seizures in children. Epilepsy Res. 2014 Feb. 108(2):345-8. [Medline].
Basu S, Barman S, Shukla R, Kumar A. Effect of oxygen inhalation on cerebral blood flow velocity in premature neonates. Pediatr Res. 2014 Feb. 75(2):328-35. [Medline].
Steiss JE, Wright JC. Respiratory alkalosis and primary hypocapnia in Labrador Retrievers participating in field trials in high-ambient-temperature conditions. Am J Vet Res. 2008 Oct. 69(10):1262-7. [Medline].
[Guideline] Lee WM, Stravitz RT, Larson AM. Introduction to the revised American Association for the Study of Liver Diseases Position Paper on acute liver failure 2011. Hepatology. 2012 Mar. 55(3):965-7. [Medline]. [Full Text].
Bhutani VK, Chima R, Sivieri EM. Innovative neonatal ventilation and meconium aspiration syndrome. Indian J Pediatr. 2003 May. 70(5):421-7. [Medline].
Biçakçi Z, Olcay L. Citrate metabolism and its complications in non-massive blood transfusions: association with decompensated metabolic alkalosis+respiratory acidosis and serum electrolyte levels. Transfus Apher Sci. 2014 Jun. 50(3):418-26. [Medline].
Blüher S, Schulz M, Bierbach U, Meixensberger J, Tröbs RB, Hirsch W, et al. Central lactic acidosis, hyperventilation, and respiratory alkalosis: leading clinical features in a 3-year-old boy with malignant meningeal melanoma. Eur J Pediatr. 2008 Apr. 167(4):483-5. [Medline].
Datta BN, Stone MD. Hyperventilation and hypophosphataemia. Ann Clin Biochem. 2009 Mar. 46:170-1. [Medline].
Frangiosa A, De Santo LS, Anastasio P, De Santo NG. Acid-base balance in heart failure. J Nephrol. 2006 Mar-Apr. 19 Suppl 9:S115-20. [Medline].
Hagiwara N, Ooboshi H, Ishibashi M, et al. Elevated cerebrospinal fluid lactate levels and the pathomechanism of calcification in Fahr's disease. Eur J Neurol. 2006 May. 13(5):539-43. [Medline].
Jaing TH, Lin JL, Lin YP, Yang SH, Lin JJ, Hsia SH. Hyperammonemic encephalopathy after induction chemotherapy for acute lymphoblastic leukemia. J Pediatr Hematol Oncol. 2009 Dec. 31(12):955-6. [Medline].
[Guideline] Polson J, Lee WM. AASLD position paper: the management of acute liver failure. Hepatology. 2005 May. 41(5):1179-97. [Medline].
Schwaderer AL, Schwartz GJ. Back to basics: acidosis and alkalosis. Pediatr Rev. 2004 Oct. 25(10):350-7. [Medline].
Weissbach A, Tirosh I, Scheuerman O, Hoffer V, Garty BZ. Respiratory alkalosis and metabolic acidosis in a child treated with sulthiame. Pediatr Emerg Care. 2010 Oct. 26(10):752-3. [Medline].