Pediatric Respiratory Alkalosis Differential Diagnoses

Updated: Dec 22, 2019
  • Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: Michael R Bye, MD  more...
  • Print

Diagnostic Considerations

Important considerations

Identification of any acid-base disturbance requires a good knowledge of physiology and blood gas interpretation.

Patients with respiratory alkalosis can present with a subtle change in blood bicarbonate. Therefore, always interpret the electrolytes and blood gas abnormalities in association with one another and put everything in clinical context upon arriving at the diagnosis.

Failure to diagnose respiratory alkalosis can lead to underdiagnosis of some potentially lethal diseases, such as pulmonary embolism or severe pneumonia.

Overzealous ventilator management may cause respiratory alkalosis which, in turn, may cause cerebral vasoconstriction and hypocalcemia, both of which could potentiate a seizure by reducing seizure threshold. Such seizures could increase the morbidity and mortality of the original disease. This can be easily avoided by routinely monitoring arterial blood gases of patients on ventilator management.

Differential Diagnoses