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Modern analyzers use ion-selective electrodes which give a normal anion gap as <11 mEq/L. Therefore, according to the new classification system, a high anion gap is anything above 11 mEq/L. A normal anion gap is often defined as being within the prediction interval of 3–11 mEq/L, [8] with an average estimated at 6 mEq/L. [9]
The osmol gap is typically calculated with the following formula (all values in mmol/L): = = ([+] + [] + []) In non-SI laboratory units: Calculated osmolality = 2 x [Na mmol/L] + [glucose mg/dL] / 18 + [BUN mg/dL] / 2.8 + [ethanol/3.7] [3] (note: the values 18 and 2.8 convert mg/dL into mmol/L; the molecular weight of ethanol is 46, but empiric data shows that it does not act as an ideal ...
Several types of metabolic acidosis occur, grouped by their influence on the anion gap. The anion gap can be increased due to relatively low levels of cations other than sodium and potassium (e.g. calcium or magnesium). 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 ...
The serum anion gap is useful for determining whether a base deficit is caused by addition of acid or loss of bicarbonate. Base deficit with elevated anion gap indicates addition of acid (e.g., ketoacidosis). Base deficit with normal anion gap indicates loss of bicarbonate (e.g., diarrhea).
Calculated osmolarity = 2 Na + Glucose + Urea (all in mmol/L) As Na+ is the major extracellular cation, the sum of osmolarity of all other anions can be assumed to be equal to natremia, hence [Na+]x2 ≈ [Na+] + [anions] To calculate plasma osmolality use the following equation (typical in the US): = 2[Na +
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The global mean fasting plasma blood glucose level in humans is about 5.5 mmol/L (100 mg/dL); [11] [12] however, this level fluctuates throughout the day. Blood sugar levels for those without diabetes and who are not fasting is usually below 6.9 mmol/L (125 mg/dL). [13]
Blood sugar levels are often normal or only mildly increased. [2] Other conditions that may present similarly include other causes of high anion gap metabolic acidosis including diabetic ketoacidosis. [2] Treatment is generally with intravenous normal saline and intravenous sugar solution. [2]