Non-Anion Gap Metabolic Acidosis

[poormansDO]

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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[cliquesh]

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

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

 

[J-Rad]

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1002945/

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.