Respiratory alkalosis is caused by alveolar hyperventilation -the opposite of respiratory acidosis. The kidneys take 2-5 days to compensate fully by excreting bicarbonate in the urine and retaining hydrogen ions. Many people tend to think that "hyperventilation" means hysteria. This is incorrect. Hyperventilation is a sign, not a diagnosis, and it has many causes:
• lung causes (hypoxaemia, pulmonary embolism, pneumonia, pneumothorax, pulmonary oedema)
• CNS causes (meningitis/encephalitis, raised intracranial pressure, stroke, cerebral haemorrhage)
• metabolic causes (fever, acute liver failure, hyperthyroidism)
• drugs (salicylate poisoning)
• Gram-negative septicaemia
• psychogenic causes (pain, anxiety).
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