Abstract
The lungs serve to defend pH by altering alveolar ventilation which serves to control the pCO2 of body fluids. Respiratory acidosis develops as a result of ineffective alveolar ventilation. Respiratory alkalosis results from hypocapnia and is defined by a PaCO2 of less than 35 mmHg in the setting of alkalemia. An increase in alveolar ventilation relative to CO2 production gives rise to respiratory alkalosis. The clinical disorders which lead to ineffective ventilation or excess ventilation are discussed in this chapter.
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References
Berger AJ, Mitchell RA, Severinghaus JW. Regulation of respiration (first of three parts). N Engl J Med. 1977;297:92–7.
Fencl V, Miller TB, Pappenheimer JR. Studies on the respiratory response to disturbances of acid–base balance, with deductions concerning the ionic composition of cerebral interstitial fluid. Am J Physiol. 1966;210:459–72.
Weinberger SE, Schwartzstein RM, Weiss JW. Hypercapnia. N Engl J Med. 1989;321:1223–31.
Brackett Jr NC, Wingo CF, Muren O, Solano JT. Acid–base response to chronic hypercapnia in man. N Engl J Med. 1969;280:124–30.
Cogan MG. Chronic hypercapnia stimulates proximal bicarbonate reabsorption in the rat. J Clin Invest. 1984;74:1942–7.
Laski ME, Kurtzman NA. Collecting tubule adaptation to respiratory acidosis induced in vivo. Am J Physiol. 1990;258:F15–20.
Madias NE, Wolf CJ, Cohen JJ. Regulation of acid–base equilibrium in chronic hypercapnia. Kidney Int. 1985;27:538–43.
Covelli HD, Black JW, Olsen MS, Beekman JF. Respiratory failure precipitated by high carbohydrate loads. Ann Intern Med. 1981;95:579–81.
Kilburn KH. Neurologic manifestations of respiratory failure. Arch Intern Med. 1965;116:409–15.
McFadden Jr ER, Gilbert IA. Asthma. N Engl J Med. 1992;327:1928–37.
Anthonisen NR. Long-term oxygen therapy. Ann Intern Med. 1983;99:519–27.
Palevsky HI, Fishman AP. Chronic cor pulmonale. Etiology and management. JAMA. 1990;263:2347–53.
Rotheram Jr EB, Safar P, Robin E. CNS disorder during mechanical ventilation in chronic pulmonary disease. JAMA. 1964;189:993–6.
Kilburn KH. Shock, seizures, and coma with alkalosis during mechanical ventilation. Ann Intern Med. 1966;65:977–84.
Mazzara JT, Ayers SM, Grace WJ. Extreme hypocapnia in the critically ill patient. Am J Med. 1974;56:450–6.
Mulhausen R, Eichenholz A, Blumentals A. Acid–base disturbances in patients with cirrhosis of the liver. Medicine. 1967;46:185–9.
Gotch FA, Sargent JA, Keen ML. Hydrogen ion balance in dialysis therapy. Artif Organs. 1982;6:388–95.
Gennari FJ. Acid–base balance in dialysis patients. Kidney Int. 1985;28:678–88.
Laffey JG, Kavanagh BP. Hypocapnia. N Engl J Med. 2002;347:43–53.
Nevin M, Colchester AC, Adams S, Pepper JR. Evidence for involvement of hypocapnia and hypoperfusion in aetiology of neurological deficit after cardiopulmonary bypass. Lancet. 1987;2:1493–5.
Ayres SM, Grace WJ. Inappropriate ventilation and hypoxemia as causes of cardiac arrhythmias. The control of arrhythmias without antiarrhythmic drugs. Am J Med. 1969;46:495–505.
Lenfant C, Sullivan K. Adaptation to high altitude. N Engl J Med. 1971;284:1298–309.
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Palmer, B.F. (2013). Respiratory Acid–Base Disorders. In: Mount, D., Sayegh, M., Singh, A. (eds) Core Concepts in the Disorders of Fluid, Electrolytes and Acid-Base Balance. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-3770-3_10
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DOI: https://doi.org/10.1007/978-1-4614-3770-3_10
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