What causes respiratory alkalosis and what are its signs?

Respiratory alkalosis results from hyperventilation that blows off too much carbon dioxide, raising blood pH above 7.45. Common causes include anxiety and panic attacks, pain, fever, early sepsis, high altitude, and mechanical ventilation set too fast. Signs and symptoms include lightheadedness, dizziness, numbness and tingling in the fingers and around the mouth, muscle spasms, and confusion. The kidneys compensate by excreting more bicarbonate, but renal compensation takes hours to days.