Non-Anion Gap Metabolic Acidosis

Discussion in 'Medical Students - DO' started by poormansDO, Jan 24, 2012.

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  1. poormansDO

    poormansDO *** member 5+ Year Member

    Dec 1, 2005
    Can someone tell me how to recognize a non-anion gap metabolic acidosis. Is a pH necessary or can you tell from the electrolytes? Can someone give me an example. thank you
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  3. cliquesh

    cliquesh 7+ Year Member

    Nov 2, 2007
    Check if pH is less than 7.4, which means acidosis

    Check if PCO2 is less than <40mmgh, if it is below 40 than you likely have a metabolic acidosis (if it is greater than 40mmgh you probably have respiratory acidosis)

    Check the anion gap (Sodium - (Chloride+Bicarb) . If that value is between 8-12, then it is a non-anion gap acidosis. If the gap is >12 then there is a anion gap. Some people use 16 instead of 12 as the cut-off point. So if sodium was 140mEq, chloride was 100 and bicarb was 30, then the anion gap would be 10. 10 falls in the rage of 8-12, therefore you have a non-anion gap acidosis.

    Diarrhea, renal tubular acidosis and hyperchloemia can cause non-anion gapped acidosis. Those are the big 3 I've seen.

    MUDPILES (methanol, uremia, DKA....) cause anion gapped acidosis
  4. J-Rad

    J-Rad Moderator Emeritus 10+ Year Member

    Read above. Read again. Understand and file away for future reading. I also add one letter to the anion-gap acidosis menominic: MUDPILERS; "R" for rhabdo. Have seen an impressive case of rhabdo with gap acidosis and Kussmal respirations in a toddler.

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