RT Book, Section
A1 Cusmano-Ozog, Kristina
A1 Chapman, Kimberly
A2 Stevenson, David K.
A2 Cohen, Ronald S.
A2 Sunshine, Philip
SR Print(0)
ID 1109799269
T1 Initial Management of Metabolic Acidosis
T2 Neonatology: Clinical Practice and Procedures
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071763769
LK accesspediatrics.mhmedical.com/content.aspx?aid=1109799269
RD 2024/04/16
AB Metabolic  acidosis  in  the  neonate  can  have  several  causes,  including  increased  acid  intake  from  an  exogenous  source,  increased  endogenous  production  of  an  acid  such  as  seen  in  an  inborn  error  of  metabolism  (IEM),  inadequate  excretion  of  acid  by  the  kidneys  or  excessive  loss  of  bicarbonate  in  urine  or  stool.  Presence  or  absence  of  an  anion  gap  (AG)  can  help  to  distinguish  the  underlying  etiology.  The  AG  can  be  calculated  using  the  following  equation:  AG  =  ([Na+])  −  ([Cl−]  +  [HCO3−]).  A  normal  AG  is  typically  less  than  16  mEq/L.1  Common  anions  that  result  in  an  elevated  AG  include  lactate  and  the  ketone  bodies  β-hydroxybutyrate  and  acetoacetate,  as  well  as  the  accumulation  of  the  toxic  organic  acids  typically  found  in  individuals  with  IEMs.