Clinical Approach to Acid-base Disorders - University at Buffalo
Clinical Approach to Acid-base Disorders - University at Buffalo
Clinical Approach to Acid-base Disorders - University at Buffalo
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Rule #4:Calcul<strong>at</strong>e the anion gap<br />
• The anion gap (AG) is an estim<strong>at</strong>e of unmeasured<br />
anions and is calcul<strong>at</strong>ed as follows:<br />
AG = Na - (Cl + HCO 3 ).<br />
Normal range is 6-12 mEq/L.<br />
Reduction in plasma proteins, particularly albumin may<br />
decrease the AG by about 1/3.<br />
• AG helps <strong>to</strong> determine if the metabolic acidosis is<br />
due <strong>to</strong> accumul<strong>at</strong>ion of [H + ] e.g. DKA or a loss of<br />
[HCO 3 ] - as in diarrhea.<br />
• Calcul<strong>at</strong>e ΔAG/ Δ [HCO - 3 ] r<strong>at</strong>io or add ΔAG <strong>to</strong><br />
[HCO 3 ] - <strong>to</strong> obtain ‘corrected’ [HCO 3 ] -
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