Anion gap is the difference of anion level and cation level within organism body fluid. The common cation that being measured are sodium ion and potassium ion, but potassium ion usually not included within the calculation due to very low amount within human body fluid (Emmett and Narins, 1977, pp. 38). The common anions used in the calculation of anion gap are chloride ion and bicarbonate ion. The calculation of anion gap as following:
[(Na2+ + K+) − (Cl- + HCO3- )]
(Wilson, 2012, p. 907)
Usually, potassium ion is not included due to low concentration and stable amount. Therefore, the calculation is adjusted as following:
[(Na2+) − (Cl- + HCO3- )]
(Emmett and Narins, 1977, pp. 38)
The normal level of anion gap is in range of 3-11 mEq/L (Winter and Pearson et al., 1990, p. 311). Higher range will cause high anion gap which leads to metabolic acidosis. Metabolic acidosis caused acidification of body fluid which due to high amount of anion and low concentration of bicarbonate ion (Alpern and Moe et al., 2012, p. 2049). There are two types of metabolic acidosis, elevated anion gap metabolic acidosis and normal anion gap metabolic acidosis
Elevated anion gap metabolic acidosis
Elevated anion gap metabolic acidosis, usually caused by ‘foreign’ anion inside human fluid. This situation might be due to accumulation of organic acid such as lactic acid. Examples of the acidosis are lactic acidosis and ketoacidosis (Oh and Carroll, 1977, pp. 815)
Given case study patient A, age 32 years old male that diagnosed Type 1 diabetes since age 14 years old. This patient was taken to hospitals due to several symptoms such as drowsiness, fever, cough, abdominal pain and vomiting. This patient also undergoes dehydration and having puls...
... middle of paper ...
...rences
Alpern, R. J., Moe, O. W. and Caplan, M. 2012. Seldin and Giebisch's the Kidney. San Diego: Academic Press [Imprint].
Costanzo, L. S. 2012. Physiology. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health.
Costanzo, L. S. 2009. Physiology. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Emmett, M. and Narins, R. G. 1977. Clinical use of the anion gap. Medicine, 56 (1), pp. 38--54.
Katsilambros, N. 2011. Diabetic emergencies. Chichester, West Sussex: Wiley-Blackwell.
Oh, M. S. and Carroll, H. J. 1977. The anion gap. The New England journal of medicine, 297 (15), pp. 814--817.
Wilson, D. A. 2012. Clinical veterinary advisor. St. Louis, MO: Elsevier Saunders.
Winter, S. D., Pearson, J. R., Gabow, P. A., Schultz, A. L. and Lepoff, R. B. 1990. The fall of the serum anion gap. Archives of internal medicine, 150 (2), p. 311.
b) Comprehensive diagnostic chemistry panel with significantly increased amylase (1626 with normal being 300-1100 U/L), total
The first test showed a decrease in blood pH and a major increase in the partial pressure of oxygen. The patient was placed on a ventilator during surgery on the date of admission, which could be the reason as to why his partial pressure of oxygen was increased. The patient’s blood pH was low in the first test. While it was barely in the normal range, the patient’s bicarb was close to being low as well. The patient was injured which resulted in fluid shifts that could have affected the amount of bicarbonate in the patient’s blood, resulting in a decrease in the blood’s pH. This means the patient was at risk for metabolic acidosis. The next day the patient’s blood pH had increased to a normal level and the bicarbonate level had also increased. The patent’s partial pressure of oxygen had also decreased, due to a decrease in the fraction of inspired oxygen, possibly from changes to the setting of the
The ratio of transport number of anion a and chloride ion, PaCl is defined by eq.(1) [7].
Baskin, S. I. , Kelly, J. B. , Maliner, B. I. , Rockwood, G. A. , Zoltani C. K. (2013). “Chapter 11
Using the previously calculated Kf, the molar masses of unknown substances A, C, and D were able to be calculated. However, given that the original Kf was slightly larger than the theoretical value, the molar
Hankins, Judy BSN,CRNI. The Role of Albumin in Fluid and Electroylte Balance. The Intravenous Nurses Society Volume 29(5), September/October 2006, p250-265
It is important however to note that the NH4 and K ions are still in
Kobau, R., Zack, M. M., Manderscheid, R., Palpant, R. G., Morales, D. S., Luncheon, C., et al.
Ware, Mark. Canadian Medical Association Journal. webmd.com. N.p. 30 August 2010. Web. 4 May 2014.
... Medicine. 3rd ed. Vol.3. Detroit: Gale, 2006.2139-2141. Gale Virtual Reference Library. Web. 3 Apr. 2014.
Whelan, R., Conrod, P. J., Poline, J., Lourdusamy, A., Banaschewski, T., Barker, G. J, Bellgrove, M. A.,
From looking at the results I can conclude that when the pH was 3 and
Duley, S. M., Cancelli, A. A., Kratochwill, T. R., Bergan, J. R., & Meredith, K. E. (1983).
Levy, Joel. The Bedside Book Of Chemistry. Vol. 1. Millers Point: Pier 9, 2011. 34-84. 1 vols. Print.
Anton, M. E., Baskin-Sommers, A. R., Vitale, J. E., Curtin, J. J., & Newman, J. P. (2012).