Key messages

• Respiratory alkalosis is present when alveolar ventilation exceeds the amount necessary to eliminate the daily load of CO 2 produced by metabolic activity.

• Systemic and metabolic consequences are different in acute and chronic respiratory alkalosis.

• In acute respiratory alkalosis there is a decrease in [HCO 3-] of about 2 mmol/l for each decrease of 10 mmHg (1.3 kPa) in PaCO2.

• In chronic respiratory alkalosis there is a decrease in [HCO 3-] of about 5 mmol/l for each decrease of 10 mmHg (1.3 kPa) in PaCO2.

• Severe hypocapnia can induce brain hypoxia and elevated cerebral lactate output.

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