The Δ Anion Gap/Δ Bicarbonate Ratio in Lactic Acidosis: Time for a New Baseline?

Key Points: The mean delta anion gap (ΔAG)/delta bicarbonate (ΔHCO) calculated using an albumin-corrected anion gap and each patient's individual baseline AG and serum HCO was 1.20. The ΔAG/ΔHCO using mean normal AG and serum HCO was 1.

Unmeasured Organic Anions as Predictors of Clinical Outcomes in Lactic Acidosis due to Sepsis.

In lactic acidosis, lactate can only explain 30% of the variance in the anion gap (AG), and the elevated AG not explained by lactate is due to unmeasured organic anions (UOAs). Some studies using less precise surrogates for UOA have suggested that UOA may predict clinical outcomes better than lactate. The aim of this study was to determine whether UOA predicts clinical outcomes better than lactate levels.

Relationship Between the Anion Gap and Serum Lactate in Hypovolemic Shock.

Previous studies evaluating patients in the Intensive Care Unit with lactic acidosis determined that the anion gap is an insensitive screening tool for elevated blood lactate. No prior study has examined the relationship between anion gap and serum lactate within the first hours of the development of lactic acidosis. Data were obtained prospectively from a convenience sample of adult trauma patients at a single level 1 trauma center.

The Anion Gap/ Bicarbonate Ratio in Early Lactic Acidosis: Time for Another Delta?

Background: The ratio of anion gap and bicarbonate (AG/HCO) is used to detect coexisting acid-base disorders in patients with high anion gap metabolic acidosis. Classic teaching holds that, in lactic acidosis, the AG/HCO is 1:1 within the first few hours of onset and subsequently rises to 1.8:1.

Assessing Acid-Base Status in Circulatory Failure: Relationship Between Arterial and Peripheral Venous Blood Gas Measurements in Hypovolemic Shock.

Background And Objectives: In severe circulatory failure agreement between arterial and mixed venous or central venous values is poor; venous values are more reflective of tissue acid-base imbalance. No prior study has examined the relationship between peripheral venous blood gas (VBG) values and arterial blood gas (ABG) values in hemodynamic compromise. The objective of this study was to examine the correlation between hemodynamic parameters, specifically systolic blood pressure (SBP) and the arterial-peripheral venous (A-PV) difference for all commonly used acid-base parameters (pH, Pco , and bicarbonate).