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Hypoxia-mediated respiratory alkalosis reduces sympathetic tone, blunts hypoxic pulmonary vasoconstriction and hypoxic cerebral vasodilation, and increases hemoglobin oxygen affinity. These effects and others can be salutary or counterproductive to tissue oxygen delivery and utilization, based upon magnitude of each effect and summation. With severe hypoxia either in the setting of profound arterial hemoglobin desaturation and reduced O2 content or poor perfusion ischemia at the global or local level, metabolic and hypercapnic acidosis develop along with considerable lactate formation and pH falling to below 6.
Although conventionally considered to be injurious and deleterious to cell function and survival, both acidoses may be cytoprotective by various anti-inflammatory, antioxidant, and anti-apoptotic mechanisms which limit total hypoxic or ischemic-reperfusion injury. Attempts to correct acidosis by giving bicarbonate or other alkaline agents under these circumstances ahead of or concurrent with reoxygenation efforts may be ill advised.
Key Points. Acid-Base Regulation and Disorders. Test your knowledge. A year-old woman comes to the office because she has had development of hair on her face, chest, and back as well as irregular menses for the past 8 months. She says she also has had easy bruising with poor wound healing during this time. Cushing syndrome is suspected, but results of urinary free cortisol test are indeterminate.
Which of the following studies is most likely to confirm a diagnosis in this patient? More Content. Respiratory Alkalosis By James L. Click here for Patient Education. Respiratory alkalosis can be. Chronic respiratory alkalosis is usually asymptomatic and has no distinctive signs.
Arterial blood gas ABG and serum electrolyte measurements. Treatment of underlying disorder. Was This Page Helpful? Yes No. Overview of Adrenal Function. Metabolic Alkalosis. Respiratory Acidosis. Acid-Base Disorders.
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