The assessment of acid-base disturbances frequently involves calculating the difference between commonly measured cations (sodium, potassium) and anions (chloride, bicarbonate) in serum. The resulting value aids in identifying the underlying cause of metabolic acidosis. An elevated result suggests the presence of unmeasured anions contributing to the acidosis, such as lactate, ketones, or toxins. As an example, in diabetic ketoacidosis, increased ketone body production leads to a higher value, indicating an elevated result type of metabolic acidosis.
This diagnostic tool is vital in differentiating between various etiologies of metabolic acidosis. Its use enables clinicians to narrow the differential diagnosis, guide appropriate investigations, and initiate targeted treatment strategies. Historically, the manual calculation was prone to errors and time-consuming. The advent of automated and readily accessible versions has significantly improved the speed and accuracy of this essential assessment, leading to better patient management.
