What is the anion gap in metabolic acidosis?

What is the anion gap in metabolic acidosis?

The anion gap allows for the differentiation of 2 groups of metabolic acidosis. Metabolic acidosis with a high AG is associated with the addition of endogenously or exogenously generated acids. Metabolic acidosis with a normal AG is associated with the loss of HCO3 or the failure to excrete H+ from the body.

What is the reference range for anion gap?

At present, the reference range of anion gap has been lowered from 8-16 to 3-11 mmol/l because of the changes in technique for measuring electrolyte. However, clinicians and textbooks still refer and use the old reference value of 8-16 mmol/l.

Why does anion gap increase in metabolic acidosis?

An increased or normal anion gap metabolic acidosis is typically due to excess acid and/or decreased base. A reduction in the anion gap is most commonly due to decreased albumin concentration as albumin is the primary unmeasured anion.

Is an anion gap of 7 normal?

Normal anion gap readings range from 3–10 milliequivalents per liter. Readings outside this range may indicate a pH imbalance, and this can stem from a wide variety of health issues. Having an anion gap reading in the low range is very rare, and it may stem from a laboratory error.

Is 17 a high anion gap?

and a normal anion gap is approximately 10—16 mEq/L. 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. Acid-base disturbances that are characterized by an increased, normal, or decreased anion gap have little mechanistically in common.

What is the significance of anion gap?

The anion gap measures the difference—or gap—between the negatively charged and positively charged electrolytes in your blood. If the anion gap is too high, your blood is more acidic than normal. If the anion gap is too low, your blood isn’t acidic enough.

What factors affect anion gap?

The anion gap is affected by changes in unmeasured ions. In uncontrolled diabetes, there is an increase in ketoacids due to metabolism of ketones. Raised levels of acid bind to bicarbonate to form carbon dioxide through the Henderson-Hasselbalch equation resulting in metabolic acidosis.

Is an anion gap of 14 high?

An anion gap number between 3 and 10 is considered normal. But the “normal” range can vary from person to person, and it may also depend on the methods your lab used to do the test.

What is anion gap in ABG?

What does anion gap 9 mean?

What does anion gap of 11 mean?

What is significance of anion gap?

Is 12 a high anion gap?

Although there are differences between laboratories and assays, the normal anion gap has traditionally been set between 8 mEq/L to 12 mEq/L. If the anion gap is greater than 12, this suggests an increased presence of unmeasured anions.

Is 13 a high anion gap?

When is anion gap increased?

High anion gap It is important because an increased anion gap usually is caused by an increase in unmeasured anions, and that most commonly occurs when there is an increase in unmeasured organic acids, that is, an acidosis3, 4). Acids (eg, lactate and pyruvate) are protons donors and must be buffered by bicarbonate.

What medications cause high anion gap?

The most common drugs and chemicals that induce the anion gap type of acidosis are biguanides, alcohols, polyhydric sugars, salicylates, cyanide and carbon monoxide.

How do you calculate an anion gap?

Ingestions Ammonium chloride and acetazolamide,ifosfamide.

  • Some cases of ketoacidosis,particularly during rehydration with Na+containing IV solutions.
  • Alcohol (such as ethanol) can cause a high anion gap acidosis in some patients,but a mixed picture in others due to concurrent metabolic alkalosis.
  • Mineralocorticoid deficiency ( Addison’s disease)
  • What are the reasons for high anion gap?

    Increased acid production or acid ingestion

  • Decreased acid excretion
  • Gastrointestinal or renal HCO 3− loss
  • What causes a high anion gap?


  • Metabolic alkalosis (increases the negative charge on albumin)
  • D-hyperlactatemia (rare,due to bacterial fermentation following small intestine resection)
  • Some medications: colchicine,NSAIDs,high-dose penicillins.
  • Poisonings: Salicylate Ethylene glycol,methanol Pyroglutamic acidosis (acetaminophen use)
  • How do you calculate ion gap?

    – 97% of patients will have OG in the range +10 to -10. – An OG value greater than 15 is considered a critical value or cutoff. – The presence of low blood pH, elevated anion gap and greatly elevated OG is a medical emergency that requires prompt treatment.