What is the anion gap?

Anion gap calculations will allow the physician to determine the cause of the patient's metabolic acidosis, which in some cases may be due to the accumulation of lactic acid or the accumulation of ketones in the blood, and the range of Anion drum also indicates the amount of bicarbonate to neutralize them and maintain blood pH.

Anion gap means the difference of cations and anions in the extracellular part. The anion gap will usually be measured in a laboratory. For example: Anion Gap = [Na+ + K+] – [Cl- + HCO3-])
These calculations will allow doctors to determine the cause of a patient's metabolic acidosis, in some cases The case may be due to the accumulation of lactic acid (this is a complication of shock due to excessive blood loss or difficulty breathing) or the accumulation of ketones in the blood (complications of diabetes mellitus) and the anion gap will also indicate bicarbonate in the body to neutralize them and maintain the pH of the blood.
In the case of acidosis with increased anion gap (also called hypochloremic acidosis), the main cause that can cause this condition is increased blood levels of phosphate, sulfate, proteins and lactate anions. . If acidosis has decreased anion gap, the cause is hypoalbuminemia or hyperkalemia, calcium and magnesium in the blood or lithium toxicity
Alkalosis with increased anion gap is usually metabolic alkalosis which causes It may be due to hyperalbuminemia due to her blood or lactate production due to increased alkalinity to lower the pH to normal.

Testing to calculate the anion gap to assess the patient for disorders related to acid-base disorders in the blood is very important to determine the cause of and at the same time monitor the treatment of these disorders. alkaline. The doctor will use the Anion gap test to find out some of the following conditions:
Anion gap test to identify diabetic ketoacidosis; Anion gap test to identify salicylic acid toxicity; Anion gap test to identify lactic acid buildup due to excessive blood loss or difficulty breathing; Determine renal failure, loss of water and ions from the gastrointestinal tract due to vomiting or sweating; Anion gap test to determine renal loss of water and ions.

Before testing the Anion gap, the patient should note a few things to avoid affecting the test results such as:
If the patient has hyperlipidemia, it may cause a decrease in the measured sodium and decrease the anion gap compared to the actual value. Normal values ​​of the anion gap are not always the same in every laboratory, because of different measurement methods. Therefore, each laboratory will print the normal value with the test results. Some drugs that increase the anion gap may include carbon anhydrase inhibitors, methanol, ethanol and salicylate... Drugs that can decrease the anion gap include acetazolamide, lithium, spironolactone and sulindac.

The treatment of metabolic acidosis with an increased anion gap is the mainstay of treatment. For example, use insulin and intravenous fluids in the treatment of diabetes to ensure good tissue perfusion. If the patient has alcoholic acidosis, it is necessary to treat with vitamin B1 and glucose to avoid Wernicke encephalopathy syndrome. For the treatment of acidosis with normal anion gap, if there is renal tubular acidosis, bicarbonate should be added because there is acid stagnation in the body, if alkaline compensation, potassium should be included in the management of proximal tubular acidosis. . To perform the Anion gap test for accurate results, patients need to go to a reputable hospital with modern equipment and highly qualified doctors. Currently, Vinmec International General Hospital is one of the leading prestigious hospitals in the country, trusted by a large number of patients for medical examination and treatment. Not only the physical system, modern equipment: 6 ultrasound rooms, 4 DR X-ray rooms (1 full-axis machine, 1 light machine, 1 general machine and 1 mammography machine) , 2 DR portable X-ray machines, 2 multi-row CT scanner rooms (1 128 rows and 1 16 arrays), 2 Magnetic resonance imaging rooms (1 3 Tesla and 1 1.5 Tesla), 1 room for 2 levels of interventional angiography and 1 room to measure bone mineral density.... Vinmec is also the place to gather a team of experienced doctors and nurses who will greatly assist in diagnosis and detection. early signs of abnormality in the patient's body. In particular, with a space designed according to 5-star hotel standards, Vinmec ensures to bring the patient the most comfort, friendliness and peace of mind.