DefinitionAlkalosis is a condition in which the body fluids have excess base (alkali). This is the opposite of excess acid (acidosis).
Causes, incidence, and risk factorsThe kidneys and lungs maintain the proper balance of chemicals, called acids and bases, in the body. Decreased carbon dioxide (an acid) or increased bicarbonate (a base) levels make the body too alkaline, a condition called alkalosis.Respiratory alkalosis is caused by low carbon dioxide levels in the blood. This can be due to:FeverBeing at a high altitudeLack of oxygenLiver diseaseLung disease, which causes you to breathe faster (hyperventilate)Salicylate poisoningMetabolic alkalosis is caused by too much bicarbonate in the blood.Hypochloremic alkalosis is caused by an extreme lack or loss of chloride, which can occur with prolonged vomiting.Hypokalemic alkalosis is caused by the kidneys' response to an extreme lack or loss of potassium, which can occur when people take certain diuretic medications.Compensated alkalosis occurs when the body returns the acid - base balance to normal in cases of alkalosis, but bicarbonate and carbon dioxide levels remain abnormal.
SymptomsConfusion (can progress to stupor or coma)Hand tremorLight-headednessMuscle twitchingNausea, vomitingNumbness or tingling in the face, hands, or feetProlonged muscle spasms (tetany)
Signs and testsAn arterial blood gas analysis and basic metabolic panel will confirm alkalosis and determine if it is respiratory alkalosis or metabolic alkalosis. Other tests may be needed to determine the cause of the alkalosis. These may include:UrinalysisUrine pH
TreatmentTo treat alkalosis, your health care provider needs to find the cause.For alkalosis caused by hyperventilation, breathing into a paper bag allows you to keep more carbon dioxide in your body, which improves the alkalosis. If your oxygen level is low, you may receive oxygen.Some people need medications to correct chemical loss (such as chloride and potassium). Your health care provider will monitor your vital signs (temperature, pulse, rate of breathing, blood pressure).
Expectations (prognosis)Most cases of alkalosis respond well to treatment.
ComplicationsArrhythmiasComaElectrolyte imbalance (such as hypokalemia)
Calling your health care providerCall your health care provider if you become confused, unable to concentrate, or unable to "catch your breath."A visit to the emergency room or call to the local emergency number (such as 911) is warranted for:Loss of consciousnessRapidly worsening symptoms of alkalosisSeizuresSevere breathing difficulties
PreventionPrevention depends on the cause of the alkalosis. Normally, people with healthy kidneys and lungs do not have significant alkalosis.
ReferencesSeifter JL. Acid-base disorders. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 120.