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The anion gap [1] [2] (AG or AGAP) is a value calculated from the results of multiple individual medical lab tests.It may be reported with the results of an electrolyte panel, which is often performed as part of a comprehensive metabolic panel.
An anion gap is usually considered to be high if it is over 12 mEq/L. High anion gap metabolic acidosis is typically caused by acid produced by the body. More rarely, it may be caused by ingesting methanol or overdosing on aspirin. [1] [2] The delta ratio is a formula that can be
Region D: the new meter's values are so inaccurate that it would fail to detect potentially dangerous hypoglycemia or hyperglycemia; and Region E: the new meter not only fails to detect potentially dangerous hypoglycemia or hyperglycemia (as in Region D), but it also mistakes one condition for the other (for example, reporting a hyperglycemic ...
Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance.Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. [5]
[4] [5] Lactic acidosis usually causes a ratio of 1.6. [5] Result 2: if the delta ratio is somewhere between low (<0.4) and high (1–2), then it is usually due to a combination of high anion gap metabolic acidosis and normal anion gap acidosis. [6]
Hyperparathyroidism – can cause hyperchloremia and increase renal bicarbonate loss, which may result in a normal anion gap metabolic acidosis. Patients with hyperparathyroidism may have a lower than normal pH, slightly decreased PaCO2 due to respiratory compensation, a decreased bicarbonate level, and a normal anion gap. [3]
In general, the cause of a hyperchloremic metabolic acidosis is a loss of base, either a gastrointestinal loss or a renal loss [citation needed]. Gastrointestinal loss of bicarbonate (HCO − 3) [citation needed] Severe diarrhea (vomiting will tend to cause hypochloraemic alkalosis) Pancreatic fistula with loss of bicarbonate rich pancreatic fluid
Winters's formula gives an expected value for the patient's P CO 2; the patient's actual (measured) P CO 2 is then compared to this. Using this information, physicians may elucidate additional causes of the acid-base derangement and identify different treatment options which may not have otherwise been considered. [9]