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In reality serum is electoneutral because of the presence of other minor cations (potassium, calcium and magnesium) and anions (albumin, sulphate and phosphate) that are not measured in the equation that calculates the anion gap. [citation needed] The normal value for the anion gap is 8–16 mmol/L (12±4).
The parameter standard bicarbonate concentration (SBC e) is the bicarbonate concentration in the blood at a P a CO 2 of 40 mmHg (5.33 kPa), full oxygen saturation and 36 °C. [13] Reference ranges for blood tests, comparing blood content of bicarbonate (shown in blue at right) with other constituents.
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).
As this value when given with blood gas results is often calculated by the analyzer, correlation should be checked with total CO 2 levels as directly measured (see below). SBC e: 21 to 27 mmol/L the bicarbonate concentration in the blood at a CO 2 of 5.33 kPa, full oxygen saturation and 37 Celsius. [15] Base excess: −2 to +2 mmol/L
Acid–base and blood gases are among the few blood constituents that exhibit substantial difference between arterial and venous values. [6] Still, pH, bicarbonate and base excess show a high level of inter-method reliability between arterial and venous tests, so arterial and venous values are roughly equivalent for these. [44]
The calculated value of the anion gap should always be adjusted for variations in the serum albumin concentration. [15] For example, in cases of hypoalbuminemia the calculated value of the anion gap should be increased by 2.3 to 2.5 mEq/L per each 1 g/dL decrease in serum albumin concentration (refer to Sample calculations, below).
Mild: blood pH mildly decreased to between 7.25 and 7.30 (normal 7.35–7.45); serum bicarbonate decreased to 15–18 mmol/L (normal above 20); the person is alert; Moderate: pH 7.00–7.25, bicarbonate 10–15, mild drowsiness may be present; Severe: pH below 7.00, bicarbonate below 10, stupor or coma may occur
High anion gap metabolic acidosis is a form of metabolic acidosis characterized by a high anion gap (a medical value based on the concentrations of ions in a patient's serum). Metabolic acidosis occurs when the body produces too much acid , or when the kidneys are not removing enough acid from the body.