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ANIONIC GAP

ANIONIC GAP. Defination and types of anionic gap. Metabolic Acidosis -- Anion Gap

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ANIONIC GAP

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  1. ANIONIC GAP Defination and types of anionic gap

  2. Metabolic Acidosis -- Anion Gap • If you determine that your patient has a primary metabolic acidosis (low pH with low HCO3), the next step is to calculate the anion gap because the anion gap helps you determine the etiology of the metabolic acidosis.

  3. The anion gap is the difference between the measured serum cations (positively charged particles) and the measured serum anions (negatively charged particles). The commonly measured cation is sodium and the measured anions include chloride and bicarbonate. • Anion gap = [Na+] - ([Cl-] + [HCO3-])

  4. The normal anion gap is 8-12. An anion gap of greater than 12 is "increased". The differential diagnosis for an elevated anion gap metabolic acidosis (simply called "anion gap acidosis") differs from the differential diagnosis for an non-elevated anion gap metabolic acidosis (simply called "non-anion gap acidosis"). 

  5. Anion gap metabolic acidosis • "MUDPILES"Methanol intoxicationUremiaDiabetic or alcoholic ketoacidosisParaldehydeIsoniazid or Iron overdoseLactic acidEthylene glycol intoxicationSalicylate intoxication

  6. Non-anion gap metabolic acidosis • Renal tubular acidosis • Diarrhea • Gastrointestinal fistula • Post-hyperventilation • Post-anion gap acidosis

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