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Estimating unmeasured anions in critically ill patients: Anion‐gap, base‐deficit, and strong‐ion‐gap
Author(s) -
Story D. A.,
Poustie S.,
Bellomo R.
Publication year - 2002
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.2002.02782_2.x
Subject(s) - anion gap , critically ill , ion , base (topology) , medicine , metabolic acidosis , base excess , acidosis , chemistry , mathematics , mathematical analysis , organic chemistry
Summary We used 100 routine blood samples from critically ill patients to establish whether correcting the anion‐gap and base‐deficit for decreased plasma albumin improves agreement with the strong‐ion‐gap for estimating unmeasured anions and whether the modifications increase the proportion of samples with levels of anion‐gap or base‐deficit above the reference ranges. We used Bland− Altman analyses to compare the methods of estimating unmeasured ions. Compared with the strong‐ion‐gap, modification reduced the limits of agreement for both the anion‐gap and the base‐deficit. The bias for the base‐deficit was also reduced but the bias for the anion‐gap was increased. The proportion of samples with an anion‐gap > 22 meq.l −1 increased from 4 to 29% (p < 0.001), and the proportion with a base‐deficit > 5 meq.l −1 in creased from 8 to 42% (p < 0.001). Consequently, metabolic acidosis from unmeasured ions in critically ill patients maybe more frequent than often recognised.