[Metabolic acidosis--a diagnostic challenge].
Metabolic acidosis can be caused by a variety of pathological conditions, but intoxication with ethylene glycol or methanol should be suspected in cases of a combined increase of osmolal and anion gaps. The determination of the gaps is based on readily available laboratory tests, and the results is known soon after the blood sample is taken. This procedure is of particular interest for hospitals where specific analyses for methanol and ethylene glycol are not available, since calculation of the gap can give an early indication of what treatment to use. Therefore, the gaps should be calculated as a routine in patients with metabolic acidosis of unknown origin. The authors describe the principles for calculating and using the gaps, and report three cases which illustrate their usefulness in practice.
Aabakken
L
L
Medisinsk klinikk, Ullevål sykehus, Oslo.
Enger
E
E
Jacobsen
D
D
Strømme
J H
JH
D000138:Acidosis / Q000139:chemically induced / Q000175:diagnosis*; D000140:Acidosis, Lactic / Q000139:chemically induced / Q000175:diagnosis; D000142:Acidosis, Respiratory / Q000139:chemically induced / Q000175:diagnosis; D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D005026:Ethylene Glycols / Q000506:poisoning; D005260:Female; D006801:Humans; D008297:Male; D000432:Methanol / Q000506:poisoning
D005026:Ethylene Glycols; D000432:Methanol
Metabolsk acidose--en diagnostisk utfordring.