Revision as of 15:32, 2 March 2023 edit AnomieBOT (talk \| contribs) Bots 6,372,405 edits Rescuing orphaned refs ("BICAR-ICU 2018" from rev 1100408181) ← Previous edit		Revision as of 21:18, 2 March 2023 edit undo Arjayay (talk \| contribs) Autopatrolled, Extended confirmed users, Page movers, Pending changes reviewers, Rollbackers 594,743 edits m Duplicate word removed Next edit →
Line 100: Because the concentration of serum sodium is greater than the combined concentrations of chloride and bicarbonate an 'anion gap' is noted. In reality serum is electoneutral because of the presence of other minor cations (potassium, calcium and magnesium) and anions (albumin, sulphate and phosphate) that are not measured in the equation that calculates the anion gap. The normal value for the anion gap is is 8–16 mmol/L (12±4). An elevated anion gap (i.e. > 16 mmol/L) indicates the presence of excess 'unmeasured' anions, such as lactic acid in anaerobic metabolism resulting from tissue hypoxia, glycolic and formic acid produced by the metabolism of toxic alcohols, ketoacids produced when acetyl-CoA undergoes ketogenesis rather than entering the tricarboxylic (Krebs) cycle, and failure of renal excretion of products of metabolism such as sulphates and phosphates. Adjunctive tests are useful in determining the aetiology of a raised anion gap metabolic acidosis including detection of an osmolar gap indicative of the presence of a toxic alcohol, measurement of serum ketones indicative of ketoacidosis and renal function tests and urinanalysis to detect renal dysfunction.

Metabolic acidosis: Difference between revisions