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Báo cáo y học: "Closing the gap on unmeasured anions"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài: Closing the gap on unmeasured anions. | Available online http ccforum.eom content 7 3 219 Commentary Closing the gap on unmeasured anions John A Kellum Associate Professor The CRISMA Laboratory Department of Critical Care Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA Correspondence John A Kellum Kellumja@ccm.upmc.edu Published online 8 May 2003 Critical Care 2003 7 219-220 DOI 10.1186 cc2189 This article is online at http ccforum.com content 7 3 219 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Many critically ill and injured patients especially those with metabolic acidosis have abnormally high levels of unmeasured anions in their blood. At the same time such patients are prone to hypoalbuminemia which makes the traditional anion gap calculation inaccurate. Thus little is known about the epidemiology and clinical consequences of an excess in unmeasured anions in the blood. Indeed even the etiology of these missing ions is often unclear. Unfortunately more precise means of quantifying unmeasured anions such as the strong ion gap SIG are cumbersome to use clinically. However a simple means of correcting the anion gap can be used to estimate SIG and may provide additional insight into this common clinical problem. Keywords acid-base balance anion gap metabolic acidosis pH strong ion difference strong ion gap Acid-base balance is among the most tightly regulated variables in human physiology. Acute changes in blood pH induce powerful regulatory effects at the level of the cell the organ and the organism 1 . Yet the mechanisms responsible for local regional and systemic acid-base control are incompletely understood and controversy exists in the literature regarding what methods should be used to understand them 2 . The use of physical chemical principles to analyze clinical acid-base disorders has been advocated by some workers 3-5 and not by others 6 7 . One difficulty with the physical chemical approach is that it cumbersome to apply .