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Recently, our institution transitioned from a chemistry analyzer that was based on dry slide technology (OCD Vitros) to a system employing wet chemistry-based assays (Siemens Vista 1500). For all measured analytes, reference ranges were verified for assays on the new instruments with at least 40 healthy individuals before going live as recommended by Clinical and Laboratory Standards Institute (CLSI) guidelines (C28-A3). However, following the implementation of the Vista instruments, clinicians began reporting an increase in low anion gaps without clinical …

88: Reassessment of Anion Gap Reference Range Following Implementation of New Chemistry Analyzers: The Fairview Experience