Difference Between Respiratory Acidosis and Respiratory Alkalosis

Difference Between Respiratory Acidosis and Respiratory Alkalosis

Respiratory Acidosis vs Respiratory Alkalosis are two sides of the same coin, both caused by imbalances in breathing, but with opposite effects on your blood's pH (acidity). Acidosis occurs when lungs fail to remove enough carbon dioxide (CO2), making blood more acidic (lower pH). Consider yourself struggling to blow out candles on your birthday cake - the smoke (CO2) stays put, creating an "acidic" situation. Alkalosis, in contrast, results from excessive CO2 removal through rapid breathing (hyperventilation), making blood more alkaline (higher pH). Think blowing out those candles a little too enthusiastically - all the smoke's gone, leaving a basic aftermath. Both conditions have distinct causes and symptoms, requiring different treatments to restore the delicate balance in your body's internal pH flow.

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Respiratory Acidosis

  • Lowers blood pH: Lungs fail to remove enough carbon dioxide, making blood more acidic.
  • Causes: Lung diseases, medication overdose, sleep apnea.
  • Symptoms: Headaches, confusion, difficulty breathing, drowsiness.
  • Treatment: Address underlying cause, oxygen therapy, medications.

Respiratory Alkalosis

  • Raises blood pH: Excessive removal of carbon dioxide makes blood more alkaline.
  • Causes: Anxiety, hyperventilation, high altitude sickness.
  • Symptoms: Dizziness, tingling hands/feet, lightheadedness, rapid breathing.
  • Treatment: Address underlying cause, breathing techniques, paper bag rebreathing (under supervision).

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Difference Between Respiratory Acidosis and Respiratory Alkalosis

Respiratory acidosis and respiratory alkalosis are two types of acid-base imbalances that occur due to changes in the levels of carbon dioxide (CO2) in the body. Here are definitions for each, followed by the differences between them:


Respiratory Acidosis

Respiratory Alkalosis


Accumulation of CO2 in the body due to inadequate ventilation or inefficient removal by lungs

Decrease in CO2 levels in the body due to hyperventilation or excessive loss

Blood pH

Below 7.35

Above 7.45


COPD, asthma, pneumonia, respiratory depression

Anxiety, hyperventilation syndrome, fever, high altitude


Headache, confusion, drowsiness, coma (if severe)

Lightheadedness, tingling, chest tightness, muscle spasms


Improve ventilation, address underlying cause

Address underlying cause, rebreathing CO2 if necessary

Compensation Mechanisms

Renal processes increase excretion of H+ and reabsorb HCO3-

Renal processes decrease H+ excretion and increase HCO3- excretion


Blood gas analysis shows elevated pCO2 and decreased pH

Blood gas analysis shows decreased pCO2 and increased pH


Electrolyte imbalances, cardiovascular issues in chronic cases

Reduced cerebral blood flow, neurological symptoms in acute cases


Blood pH and gas levels

Blood pH and gas levels


Bronchodilators, antibiotics, respiratory support

Address underlying cause, anxiety management techniques

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What is Respiratory Acidosis?

Respiratory acidosis occurs when your lungs can't efficiently remove carbon dioxide, a waste product from metabolism. This buildup makes your blood more acidic (lower pH), potentially causing headaches, confusion, and difficulty breathing. Causes include lung diseases, sleep apnea, and drug overdoses. Treatment focuses on improving lung function and restoring pH balance.

Key Features of Respiratory Acidosis:

  • Cause: Respiratory acidosis happens when your lungs do not eliminate enough carbon dioxide (CO2) from your bloodstream. This CO2 accumulation reduces your blood's pH, making it more acidic.
  • Symptoms: Common signs include disorientation, headache, sleepiness, shortness of breath, and fast breathing. In extreme situations, convulsions and coma may ensue.
  • Underlying causes include chronic obstructive pulmonary disease (COPD), asthma, pneumonia, drug overdose, and sleep apnea.
  • Treatment aims to improve lung function and remove excess CO2. This might include oxygen treatment, mechanical ventilation, and treating the underlying disease.

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What is Respiratory Alkalosis?

Respiratory alkalosis occurs when you over breathe (hyperventilate), causing excess carbon dioxide elimination and making your blood overly alkaline (high pH). This might result in tingling, dizziness, lightheadedness, and anxiety. It is commonly caused by anxiety episodes, high elevations, or medical issues such as lung infections. The treatment seeks to address the underlying problem while also slowing breathing.

Key Features of Respiratory Alkalosis:

  • Cause: Respiratory alkalosis occurs when you hyperventilate (breathe too quickly and deeply), resulting in excessive CO2 clearance from your bloodstream. This increases your blood's pH, making it more alkaline.
  • Symptoms: Common signs include dizziness, lightheadedness, tingling in the hands and feet, and muscular cramps. In extreme circumstances, seizures and loss of consciousness may ensue.
  • Underlying reasons include anxiety, panic episodes, high altitude exposure, brain damage, and certain drugs.
  • Treatment focuses on slowing the breathing rate and restoring normal blood pH. This might include breathing methods, paper bag breathing, and treating the underlying issue.

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Similarities Between Respiratory Acidosis and Respiratory Alkalosis

  • Respiratory acidosis and respiratory alkalosis are the two kinds of acid-base defects.
  • Both disorders can cause symptoms in a variety of physiological systems.
  • Both disorders are diagnosed via blood gas analysis.
  • Renal functions may provide compensatory strategies for regulating acid-base balance.
  • Treatment for these illnesses entails treating the root cause.

Both respiratory acidosis and respiratory alkalosis alter the body's delicate acid-base balance, affecting blood pH. However, their origins and outcomes differ greatly. Respiratory acidosis occurs when the lungs do not extract enough carbon dioxide, resulting in a buildup of acid and a lower blood pH. This can happen owing to a variety of reasons, including chronic obstructive pulmonary disease (COPD) or pneumonia. Respiratory alkalosis, on the other hand, is caused by the excessive elimination of carbon dioxide by fast breathing (hyperventilation), which results in a higher blood pH (more alkaline). This might be caused by worry, high altitude illness, or certain drugs. In essence, respiratory acidosis is the retention of acid, whereas respiratory alkalosis is the elimination of too much acid.

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What are the key differences between Respiratory Acidosis and Respiratory Alkalosis?

Respiratory Acidosis is characterized by high levels of carbon dioxide and acidic pH, whereas Respiratory Alkalosis is marked by low levels of carbon dioxide and alkaline pH.

What are the similarities between Respiratory Acidosis and Respiratory Alkalosis?

Both conditions involve imbalances in pH levels caused by respiratory issues, albeit in opposite directions—acidosis involves excess carbon dioxide retention, while alkalosis involves excessive carbon dioxide expulsion. Additionally, both can lead to serious health complications if left untreated.

Can Respiratory Acidosis and Respiratory Alkalosis Occur Simultaneously?

Yes, in some cases, respiratory acidosis and alkalosis can coexist, especially in conditions where compensatory mechanisms are disrupted or in individuals with complex medical conditions.

What are the Complications of Untreated Respiratory Acidosis and Respiratory Alkalosis?

Untreated respiratory acidosis can lead to arrhythmias, coma, and even death, while untreated respiratory alkalosis can cause seizures, cardiac arrhythmias, and electrolyte imbalances.

How are Respiratory Acidosis and Respiratory Alkalosis Managed?

Management involves treating the underlying cause, providing oxygen therapy, ventilatory support if necessary, and sometimes administering medications to correct acid-base imbalances.

Can Respiratory Acidosis or Alkalosis Develop Suddenly?

Yes, both respiratory acidosis and alkalosis can develop suddenly, especially in acute conditions such as asthma exacerbations, pulmonary embolism, or traumatic chest injuries.

Are There Any Lifestyle Changes That Can Help Prevent Respiratory Acidosis or Respiratory Alkalosis?

Maintaining a healthy lifestyle, avoiding smoking, managing chronic respiratory conditions, and practicing stress-reduction techniques can help prevent exacerbations of respiratory acidosis and alkalosis.