Respiratory alkalosis: Causes, treatment, and prevention

A person may breathe too fast due to anxiety, overdosing on certain medications, or using a ventilator.

Symptoms of respiratory alkalosis may include muscle spasms, irritability, dizziness, and nausea.

Respiratory alkalosis is one possible classification of an acid-alkaline imbalance in the body. The human body normally works to maintain a pH level of around 7.35–7.45.

Treating the underlying cause with medications or making changes to ventilator settings, if applicable, can help treat this condition.


At its simplest definition, respiratory alkalosis almost always means that a person is breathing so fast that they are getting rid of carbon dioxide in excess. Carbon dioxide is an acid.

As a result of this carbon dioxide loss, the body’s pH becomes more alkaline, the opposite of acidic.

Because some of the body’s processes work in a tightly controlled range of pH levels, it is important that people maintain a pH balance that is close to normal.

In some cases, a doctor may consider having a more alkaline pH less dangerous than having an acidic one. However, some causes of respiratory alkalosis can be high-risk and require more urgent medical attention.

Doctors will usually divide the potential causes of respiratory alkalosis into three categories. All of these causes result in hyperventilation, or breathing too fast.

These three categories are:

1. Related to a medical condition

Numerous medical conditions can cause respiratory alkalosis. Some of these include:

  • atrial flutter
  • panic disorder
  • liver disease
  • pneumothorax, which occurs when air in the pleural cavity causes a collapsed lung
  • pulmonary embolism
  • overdose of salicylate medications, such as aspirin

Pregnancy can also cause respiratory alkalosis. This is because a woman tends to breathe faster during the third trimester due to the metabolic demands of the growing fetus.

Doctors recommend treatment for respiratory alkalosis based on what is causing the underlying illness.

If the cause is related to a ventilator setting, such as it being too fast, having too high a supplemental oxygen setting, or giving too large a volume in each breath, the doctor may modify the settings so that the person can breathe more suitably.

This can help correct respiratory alkalosis quickly.

Other treatments may include:

  • administering an opioid pain reliever or anti-anxiety medication to reduce hyperventilation
  • providing oxygen to help keep a person from hyperventilating
  • correcting any heart rhythm abnormalities by using medications or direct current cardioversion, which delivers an electric shock to reset the heart’s rhythm

Because respiratory alkalosis is not usually life-threatening and the body often works to correct the imbalance, a doctor may not treat the higher-than-normal pH level aggressively.

Instead, they will treat the underlying condition to help a person’s pH achieve a more normal value with time.


While respiratory alkalosis is not life-threatening, the underlying cause might be. The condition will likely resolve if a person or doctor corrects the underlying cause.

The body may try to self-correct the pH imbalance that comes with respiratory alkalosis, such as by having the kidneys increase excretion of alkaline and reduce excretion of acid.

Source: Read Full Article