Ver el código de «Anion gap acidosis»

==Background==

==Clinical Features==
*Signs/symptoms of underlying disease
*Compensatory [[tachypnea]]

==Differential Diagnosis==
{{Anion gap metabolic acidosis}}

==Evaluation==
*AG = Na - (Cl  +  HCO3)
*Normal Anion Gap = 12+/-4 (8-16)
*12-20 mEq/L when including K+
*Primary acidosis if pH <7.38
*HCO3 <24 = metabolic acidosis
*Always determine if there is another acid/base process occurring
**Primary respiratory acidosis if pCO2 > pCO2expected
**Primary respiratory alkalosis if pCO2 < pCO2expected 
***use Winter's formula: PCO2 (expected) = (1.5 x [HCO3–] + 8) ± 2
***In acute setting PCO2 should fall by 1 mmHg for every 1 mEq fall in HCO3
**Concurrent metabolic alkalosis if delta-delta > 28
**Delta-Delta = (AG - 12) + HCO3

==Management==
*Treat source
*Correct any [[respiratory acidosis]]
*[[Bicarbonate]]
**HCO3 dose in mEq = 0.5(wt in kg) x (24 - measured HCO3)
**Each bicarb 0.5mEq/kg causes 1 meq/L rise in HCO3
**Consider for:
***Bicarb <4
***pH <7.20 AND shock/myocardial irritability
***Severe hyperchloremic acidemia
****Lost bicarbonate would take days to replenish

==Disposition==

==See Also==
*[[Non anion gap acidosis]]

==External Links==

==References==
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[[Category:FEN]][[Category:Renal]]