Alkalosis is a condition in which the body fluids have become excessively alkaline (i.e., the pH rises above 7.45). The kidneys and lungs maintain the proper balance of acids and bases in the body; decreased carbon dioxide or increased bicarbonate levels make the body too alkaline. Symptoms may include confusion, which can progress to stupor or coma; hand tremor; light-headedness; muscle twitching; nausea and vomiting; numbness or tingling in the face or extremities; and prolonged muscle spasms (tetany).


Types of alkalosis

There are two main types of alkalosis: respiratory and metabolic.


Respiratory alkalosis is caused by low carbon dioxide levels in the blood. This can be due to: fever; being at a high altitude; lack of oxygen; liver disease; lung disease causing hyperventilation; and salicylate poisoning.


Metabolic alkalosis is caused by too much bicarbonate in the blood.


Other forms of alkalosis are: hypochloremic alkalosis, caused by an extreme lack or loss of chloride, which can occur with prolonged vomiting; hypokalemic alkalosis, caused by the kidneys' response to an extreme lack or loss of potassium, which can occur when people take certain diuretic medications; and compensated alkalosis, which occurs when the body returns the acid/base balance to normal in cases of alkalosis, but bicarbonate and carbon dioxide levels remain abnormal.



An arterial blood gas analysis or basic metabolic panel will confirm alkalosis and determine if it is a respiratory alkalosis or a metabolic alkalosis. Other tests may be needed to determine the cause of the alkalosis. These may include: litmus paper (urine dipstick tests), urinalysis, and urine pH.



Treatment of alkalosis depends on finding the specific cause. For alkalosis caused by hyperventilation, breathing into a paper bag causes the retention of more carbon dioxide and improves the alkalosis. If the oxygen level is low, oxygen may be supplied to the patient to help the alkalosis. Some people need medications to correct chemical loss (such as chloride and potassium).