Alright. In this video, I'm going to talk about respiratory alkalosis
and what ABG values you will see with uncompensated respiratory alkalosis,
partially compensated respiratory alkalosis, and fully compensated respiratory alkalosis.
We will also cover the causes, symptoms, and treatment of respiratory alkalosis as well.
Okay. When we look at the pH here, if it is over 7.45, we know we have
alkalosis present and then we just need to see who to blame for the alkalosis.
And when we look at PaCO2, if that is low, under 35, then we know the respiratory system
is to blame for the alkalosis, so we have respiratory alkalosis.
And then, when we look at HCO3, which is bicarb, that really represents the metabolic system.
If that value is within the normal range, between 22 and 26,
that means the metabolic system is chilling out. They're not trying to fix the situation, right?
They're not trying to compensate for this respiratory alkalosis.
So in this case, we have uncompensated respiratory alkalosis.
Then, if we go to the second row, if our pH is over 7.45, again we have alkalosis.
Our PaCO2 is low, under 35, so we know we have respiratory alkalosis.
But let's look what's going on here. Bicarb is under 22, which means it's acidic.
It is trying to compensate for this respiratory alkalosis by becoming more acidic. Has it fully
compensated for the respiratory system messing up? No. Because our pH is still out of range,
right? It's still over 7.45. But it's trying. So here we have partially-compensated respiratory
alkalosis. The respiratory system's to blame for the alkalosis. Metabolic system's trying
to compensate, but has not fully compensated because that pH is not within normal range.
Third row here. If we have a pH that is within normal
range -- so it is between 7.35 and 7.45 -- then that's normal. But if it's a little bit on the
basic side, meaning it's like 7.44 or 7.45, then we may suspect we have some compensation going on.
And sure enough, when we go to the next row here, we can see that PaCO2
is low, which means we probably have respiratory alkalosis here.
And I suspect that the metabolic system has saved the day.
And sure enough, when we look at bicarb, HCO3, it is low. It is acidic. So in this situation,
we had some respiratory alkalosis that the metabolic system has compensated for.
It has become a lot more acidic to help counteract the basic nature of the respiratory system.
So we have fully compensated respiratory alkalosis. That metabolic system was
able to come in, fix the situation, and get the pH into a normal range.
Now let's talk about the causes of respiratory alkalosis.
If you recall, with respiratory acidosis, the big issue was with hypoventilation. The patient
has some kind of respiratory condition and they're not breathing effectively. Well, with respiratory
alkalosis, the issue is with hyperventilation. It could be hyperventilation due to fear,
due to anxiety, possibly due to a salicylate toxicity situation,
like if they overdosed on aspirin. It could also be due to high altitude, pain, shock, or trauma.
In terms of the signs and symptoms, a patient who has respiratory alkalosis may be short of breath.
They may feel dizzy. They may have anxiety. They may have chest pain and they may also
have numbness in their feet and their hands. In terms of treatment, we're going to want to
treat whatever the underlying condition is. If the patient has anxiety, we can give them antianxiety
medications. We can also have the patient breathe into a paper bag to help retain more CO2 to help
resolve this respiratory alkalosis as well. Okay. So that's it with respiratory alkalosis.
In my next video, we will talk about metabolic acidosis, which is super important to know,
and we'll go through all the same good information for that condition.