Re: Respiratory alkalosis

[Guest guest]

At 09:20 PM 11/3/99 -0600, you wrote:

>Howdy group,

>

>I recently came across a handout that apparently came from a W.B.

>EMS text. Although I have no idea which particular book this is from, the

>handout is copyrighted 1992 and the handout is # 2-13, titled " Common Causes

>of Major Acid-Base Disorders " .

>

>Under the heading of Respiratory Alkalosis there is the usual list of

>potential etiologies, but there was one that I haven't seen before. The list

>suggests gram negative sepsis. Now I know sepsis should be included in the

>list of possible causes, but why only gram negative infections? Why would a

>gram positive bacterial infection be excluded?

>

>Donn

>

Donn,

I have searched my textbooks in biochemistry and microbiology, but I cannot

come up with a convincing argument why this would be more prevalent in gram

negative bacteria. It probably has to do with differential metabolism of

the bacteria or the diiferential locations of infection. One of my texts -

" Nutritional Biochemisty and Metabolism " has one paragraph on the matter -

" The onset of fever from any cause is accompanied by an accelerated

respiratory rate and an exaggerated loss of CO2 from the plasma. This

leads to typical respiratory alkalosis, with pronounced increase in plasma

Ph and a slight decrease in plasma bicarbonate " (Beisel, W.R., Nutrition

and Infection (ch. 16) in " Nutritional Biochemistry and Nutrition " , M.C.

Linder, ed., 1985)

Seems to me this would indicate all sepsis would potentially produce

respiratory alkalosis from hyperventillation. Unfortunately, my wife has

my copy of Guyton's text of medical physiology up at her office, so I

couldn't check that text

Marc M. Meyer, RN, MS, LP

Engineer/Operator-Paramedic, Houston Fire Department

Staff Nurse, St. Luke's Episcopal Hospital