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Updated: May 14, 2026
06:47
Measurement and Analysis of Extracellular Acid Production to Determine Glycolytic Rate
Published on: December 12, 2015
Problem-based review: A patient with metabolic acidosis
Russell Allan1, Christopher Foster
1ST5 Acute Medicine, Western Infirmary, Glasgow, UK. russellallan@doctors.org.uk
Acute Medicine
|February 1, 2013
Summary
Metabolic acidosis is a common issue in acute medical patients. Calculating the anion gap, corrected for albumin, and using the delta ratio aids in diagnosing complex cases with multiple metabolic problems.
Area of Science:
- Nephrology
- Internal Medicine
- Critical Care Medicine
Background:
- Metabolic acidosis is a frequent metabolic disturbance encountered in acutely ill patients.
- Effective management necessitates a comprehensive diagnostic strategy due to diverse etiologies.
- Identifying the underlying cause is crucial for appropriate treatment.
Purpose of the Study:
- To outline a structured approach for investigating metabolic acidosis in acute medical patients.
- To highlight the utility of specific calculations in diagnosing complex cases.
Main Methods:
- Review of diagnostic principles for metabolic acidosis.
- Emphasis on calculation of the anion gap, with albumin correction.
- Application of the delta ratio for complex acid-base disturbances.
Main Results:
- Anion gap calculation, adjusted for albumin, is a key diagnostic tool.
- The delta ratio proves valuable in identifying mixed acid-base disorders.
- A systematic approach improves diagnostic accuracy.
Conclusions:
- A structured investigation, including anion gap and delta ratio, is essential for managing metabolic acidosis.
- These calculations are particularly useful in patients with coexisting metabolic derangements.
- Accurate diagnosis through methodical evaluation leads to effective patient management.
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