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Anion gap can be classified as either high, normal or, in rare cases, low. Laboratory errors need to be ruled out whenever anion gap calculations lead to results that do not fit the clinical picture. Methods used to determine the concentrations of some of the ions used to calculate the anion gap may be susceptible to very specific errors.
The anion gap (AG) without potassium is calculated first and if a metabolic acidosis is present, results in either a high anion gap metabolic acidosis (HAGMA) or a normal anion gap acidosis (NAGMA). A low anion gap is usually an oddity of measurement, rather than a clinical concern.
High anion gap metabolic acidosis is typically caused by acid produced by the body. More rarely, it may be caused by ingesting methanol or overdosing on aspirin . [ 1 ] [ 2 ] The delta ratio is a formula that can be used to assess elevated anion gap metabolic acidosis and to evaluate whether mixed acid base disorder (metabolic acidosis) is present.
Elevated protein (albumin, globulins) may theoretically increase the anion gap but high levels are not usually encountered clinically. Hypoalbuminaemia, which is frequently encountered clinically, will mask an anion gap. As a rule of thumb, a decrease in serum albumin by 1 G/L will decrease the anion gap by 0.25 mmol/L [citation needed]
As with any buffer system, the pH is balanced by the presence of both a weak acid (for example, H 2 CO 3) and its conjugate base (for example, HCO − 3) so that any excess acid or base introduced to the system is neutralized.
Air ioniser and purifier with its dust collection plates removed. Air ionisers are used in air purifiers to remove particles from air. [3] Airborne particles become charged as they attract charged ions from the ioniser by electrostatic attraction. The particles in turn are then attracted to any nearby earthed (grounded) conductors, either ...
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Diagnoses can be done by doing an ABG (Arterial Blood Gas) laboratory study, with a pH <7.35 and a PaCO2 >45 mmHg in an acute setting. Patients with COPD and other Chronic respiratory diseases will sometimes display higher level of PaCO2 with HCO3- >30 and normal pH. [citation needed] [2]
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