The anion gap does not accurately screen for lactic. Anion gap acidoses have a very different differential diagnosis than nongap acidoses. Determining the serum anion gap is commonly used in the differential diagnosis of metabolic acidosis. Acid base disorders, anion gap, delta gap, stewart acid base, strong ion difference. The anion gap does not accurately screen for lactic acidosis in emergency department patients b d adams, t a bonzani, and c j hunter b d adams, t a bonzani, c j hunter, us army, department of emergency medicine, san antonio uniformed services health education consortium, brooke army medical center, san antonio, tx, usa. To critically discuss the treatment of metabolic acidosis and the main mechanisms of disease associated with this disorder. The anion gap ag represents the difference between the measured anion and cation concentrations in the serum, and is used by clinicians to diagnose acid base problems, especially in unsuspected cases of acidosis, alkalosis, drug poisoning, and disease states, particularly in emergency rooms and intensive care units,15 and as a quality. It is the difference between the sum of measured anions chloride and bicarbonate. A recent article in ajkd by vichot and rastegar discusses the use of anion gap in metabolic acidosis. This entity is used in the detection and analysis of acidbase disorders, assessment of quality control in the chemical laboratory, and detection of such disorders as multiple. The incidence of admission hypoalbuminaemia was 57%, after correction of albumin the incidence of a raised anion gap 18 mmol increase from 28% to 44%.
Increased anion gap metabolic acidosis as a result of 5oxoproline pyroglutamic acid. The serum anion gap, calculated from the electrolytes measured in the chemical laboratory, is defined as the sum of serum chloride and bicarbonate concentrations subtracted from the serum sodium concentration. Trastornos del metabolismo acidobase nefrologia al dia. Complex acidbase disorders robert m centor, md facp. An anion gap of 17 or higher represents an increased anion gap, and an anion gap of 9 or lower represents a decreased anion gap. If the calculated value for the anion gap is too high or too low, it. It may be reported with the results of an electrolyte panel, which is often performed as part of a comprehensive metabolic panel the anion gap is the difference between certain measured cations positively charged ions and the measured anions negatively charged ions in serum, plasma.
Description of one clinical case of severe oral methanol poisoning. The serum anion gap is a common tool used in clinical practice. Determining if a patients acidosis also has an elevated anion gap. A systematic approach to diagnosis of metabolic acidosis is valuable.