Figure 612

Respiratory alkalosis is the most frequent acid-base disorder encountered because it occurs in normal pregnancy and high-altitude residence. Pathologic causes of respiratory alkalosis include various hypoxemic conditions, pulmonary disorders, central nervous system diseases, pharmacologic or hormonal stimulation of ventilation, hepatic failure, sepsis, the anxiety-hyper-ventilation syndrome, and other entities. Most of these causes are associated with the abrupt occurrence of hypocapnia; however, in many instances, the process might be sufficiently prolonged to permit full chronic adaptation to occur. Consequently, no attempt has been made to separate these conditions into acute and chronic categories. Some of the major causes of respiratory alkalosis are benign, whereas others are life-threatening. Primary hypocapnia is particularly common among the critically ill, occurring either as the simple disorder or as a component of mixed disturbances. Its presence constitutes an ominous prognostic sign, with mortality increasing in direct proportion to the severity of the hypocapnia [2].

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