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==Pathophysiology==


==Pathophysiology==
===Alkalosis===
===Alkalosis===
As [[blood plasma]] hydrogen ion concentration decreases, caused by respiratory or metabolic [[alkalosis]], freely ionized calcium concentration decreases. This freely ionized calcium is the biologically active component of blood calcium. Since a portion of both hydrogen ions and calcium are bound to serum [[albumin]], when blood becomes alkalotic, bound hydrogen ions dissociate from albumin, freeing up the albumin to bind with more calcium and thereby decreasing the freely ionized portion of total serum calcium. For every 0.1 increase in pH, ionized calcium decreases by about 0.05 mmol/l.  
In alkalosis, hydrogen ions dissociate from the negatively charged albumin, which allows for increased calcium binding and leads to a decreased concentration of free calcium.
 
For an increase in pH of 0.1 unit, there is an approximately 0.05 mmol/L (0.1 mEq/L) fall in the serum level of ionized Ca<sup>++</sup>.
 
===Respiratory Alkalosis===
Reduced ionized calcium concentration and [[hypocapnia]] associated with [[hyperventilation]] may contribute to symptoms of [[vasoconstriction]] including [[lightheadedness]], [[fainting]], and [[parasthesia]].


This hypocalcemia related to alkalosis is partially responsible for the cerebral [[vasoconstriction]] that causes the [[lightheadedness]], [[fainting]], and [[parasthesia]] often seen with [[hyperventilation]].
===Protein Binding===
Calcium binding to globulin is relatively small (1.0 g of globulin binds 0.2–0.3 mg of calcium) and generally does not influence the total serum calcium concentration.


==References==
==References==
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Revision as of 15:46, 27 March 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Pathophysiology

Alkalosis

In alkalosis, hydrogen ions dissociate from the negatively charged albumin, which allows for increased calcium binding and leads to a decreased concentration of free calcium.

For an increase in pH of 0.1 unit, there is an approximately 0.05 mmol/L (0.1 mEq/L) fall in the serum level of ionized Ca++.

Respiratory Alkalosis

Reduced ionized calcium concentration and hypocapnia associated with hyperventilation may contribute to symptoms of vasoconstriction including lightheadedness, fainting, and parasthesia.

Protein Binding

Calcium binding to globulin is relatively small (1.0 g of globulin binds 0.2–0.3 mg of calcium) and generally does not influence the total serum calcium concentration.

References