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Anion gap can be classified as either high, normal or, in rare cases, low. Laboratory errors need to be ruled out whenever anion gap calculations lead to results that do not fit the clinical picture. Methods used to determine the concentrations of some of the ions used to calculate the anion gap may be susceptible to very specific errors.
Winters's formula, [1] named after R. W. Winters, [2] is a formula used to evaluate respiratory compensation when analyzing acid-base disorders in the presence of metabolic acidosis. [ 3 ] [ 4 ] It can be given as:
k H CO 2 is a constant including the solubility of carbon dioxide in blood. k H CO 2 is approximately 0.03 (mmol/L)/mmHg; p CO 2 is the partial pressure of carbon dioxide in the blood; Combining these equations results in the following equation relating the pH of blood to the concentration of bicarbonate and the partial pressure of carbon ...
For a list of the common anions responsible, see high anion gap metabolic acidosis. KULT is probably the easiest of the mnemonics to use (Ketones, Uremia, Lactate, Toxins). Toxins are an uncommon cause of high anion gap metabolic acidosis – a list of the commonest toxins is ACE GIFTs [ibid]. Metformin as a pure toxicological cause is ...
While carbon dioxide defines the respiratory component of acid–base balance, base excess defines the metabolic component. Accordingly, measurement of base excess is defined, under a standardized pressure of carbon dioxide, by titrating back to a standardized blood pH of 7.40. The predominant base contributing to base excess is bicarbonate ...
In respiratory acidosis, the kidney produces and excretes ammonium (NH 4 +) and monophosphate, generating bicarbonate in the process while clearing acid. There is also an excretion of Cl- and a reabsorption of sodium, resulting in a negative urinary anion gap.
Depending on the brand of windshield wiper fluid used, Burgett says the methanol, ethanol, isopropyl alcohol and glycols, or a combination of these ingredients in the formula, can help lower the ...
Urine NH 4 + is difficult to measure directly, but its excretion is usually accompanied by the anion chloride. A negative urine anion gap can be used as evidence of increased NH 4 + excretion. In a metabolic acidosis without a serum anion gap: A positive urine anion gap suggests a low urinary NH 4 + (e.g. renal tubular acidosis).