The effect of acute respiratory alkalosis on anaerobic performance: a systematic review

High-intensity short-duration exercise relies predominantly on anaerobic metabolism, leading to rapid accumulation of hydrogen ions and metabolic acidosis, which impairs muscle function and performance. Acute respiratory alkalosis induced by voluntary hyperventilation (VH) has been proposed as a simple, non-pharmacological strategy to modulate acid-base balance and potentially enhance anaerobic performance. This systematic review aimed to evaluate the effects of VH-induced respiratory alkalosis on anaerobic performance outcomes and to explore potential underlying mechanisms. A systematic search of PubMed, Scopus, EBSCO and Web of Science databases identified 21 eligible studies involving healthy and trained participants. Overall, the findings were inconsistent. While some studies reported improvements in peak power output, mean power output, repeated sprint performance, or work capacity, others found no significant benefit or even slight impairments. Proposed mechanisms include elevated extracellular pH, accelerated phosphocreatine (PCr) resynthesis, facilitated H⁺ efflux, and altered substrate utilization. However, these effects appear highly context-dependent, varying according to VH protocol (duration, timing, and PetCO₂ level), exercise modality, and participant training status. In conclusion, VH-induced acute respiratory alkalosis shows promise as a potential ergogenic aid for certain high-intensity short-duration activities, but its efficacy remains variable. Future research should focus on standardizing protocols and elucidating the precise physiological mechanisms through advanced measurement techniques. Proposed mechanistic pathway linking voluntary hyperventilation-induced respiratory alkalosis to anaerobic performance. The scientific content and mechanisms were developed and verified by the authors based on the cited literature. The figure was created using the generative AI tool Grok as a graphical design aid.