ACID BASE DISORDERS-ALKALEMIA & CALCIUM

SUMMARY

1. Significant alkalemia can cause the diffuse paresthesias/numbness and muscle spasms we usually associate with acute hyperventilation.

2. High pH increases the fraction of bound calcium. The resulting decrease in ionized calcium produces these symptoms.

3. There is no change in total serum calcium.

4. This effect also can be induced by rapid overload with intravenous HCO₃^- or with citrate (massive blood transfusion).

Reference(s)

Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].