Metabolic Acidosis-Elevated Anion Gap (Anion Gap Metabolic Acidosis, AGMA)


Etiology

Ketoacidoses

Intoxications

Other

Etiology (GOLDMARK Mnemonic)

Diagnosis

Serum Chemistry

  • Serum Bicarbonate: decreased

Serum Anion Gap (see Serum Anion Gap)

  • Elevated

Arterial Blood Gas (ABG) (see Arterial Blood Gas)

  • Decreased Serum Bicarbonate with Respiratory Compensation: assessment of the appropriateness of respiratory compensation can be determined using standard rules of expected compensation (see Acid-Base Physiology, [[Acid-Base Physiology]])

Serum Osmolality (see Serum Osmolality)

  • Serum Osmolal Gap: variable (depending on the etiology)

Clinical Manifestations

Pharmacologic Manifestations

Enhanced Effect of Neuromuscular Junction Antagonists (see Neuromuscular Junction Antagonists)

  • Physiology: acidosis potentiates the effect of neuromuscular junction antagonists
  • Agents

Renal Manifestations

  • Anion Gap Metabolic Acidosis (AGMA)

Treatment

References