For each set of the following biochemical and arterial blood gas parameters:
Any reasonable scenario accepted that was both biochemically correct AND clinically likely.
Test |
Value |
Normal Range |
Sodium |
135 mmol/L |
135 – 145 |
Potassium |
4.0 mmol/L |
3.2 – 4.5 |
Chloride |
105 mmol/L |
100 – 110 |
Bicarbonate* |
22 mmol/L |
24 – 32 |
pH* |
7.60 |
7.35 – 7.45 |
pCO2* |
23 mmHg (3.0 kPa) |
35 – 45 (4.6 – 5.9) |
Acute respiratory alkalosis. Clinical scenario – Psychogenic hyperventilation
Let us dissect these results systematically.
Thus, this is a respiratory alkalosis with virtually no other biochemical changes. A scenario which might explain these findings may be any cause of hyperventilation:
Barker, E. S., et al. "The renal response in man to acute experimental respiratory alkalosis and acidosis." Journal of Clinical Investigation 36.4 (1957): 515.
Foster, Guy T., Nostratola D. Vaziri, and C. S. Sassoon. "Respiratory alkalosis." Respiratory care 46.4 (2001): 384-391.
Giebisch, Gerhard, et al. "The extrarenal response to acute acid-base disturbances of respiratory origin." Journal of Clinical Investigation 34.2 (1955): 231.