High Anion Gap Metabolic Acidosis (HAGMA)
C | Carbon Monoxide, Cyanide |
A | Alcohol, Alcoholic Ketoacidosis |
T | Toluene |
M | Metformin, Methanol |
U | Uraemia |
D | Diabetic Ketoacidosis |
P | Paraldehyde, Phenformin, Paracetamol, Propylene glycol |
I | Iron, Isoniazid |
L | Lactic acidosis (any cause) |
E | Ethylene glycol |
S | Salicylates |
Causes of Lactic Acidosis
Type A: Imbalanced oxygen supply and demand | Type B: Metabolic derangements |
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Non-anion Gap Metabolic Acidosis (NAGMA)
U | Ureteroenterostomy |
S | Small bowel fistula |
E | Extra chloride, Normal saline hydration |
D | Diarrhoea |
C | Carbonic anhydrase inhibitors (acetozolamide, topiramate…) |
A | Adrenal insufficiency |
R | Renal tubular acidosis |
P | Pancreatic fistula |
Causes of a low anion gap
Increased cations | Calcium, magnesium, lithium, multiple myeloma |
Decreased anions | Dilution, hypoalbuminaemia |
Artefactual | Bromism, Iodism, Propylene glycol, Triglycerides |
Metabolic Alkalosis
C | Contraction (volume contraction) |
L | Liquorice, Diuretics (Lasix™) |
E | Endocrine (Bartter’s, Cushing’s, Conn’s) |
V | Vomiting, NG suction (Chloride loss) |
E | Excess alkali (Antacids, Dialysis, Milk-Alkali Syndrome) |
R | Refeeding alkalosis |
R | Renal bicarbonate retention (Hypochloraemia, Hypokalaemia, Chronic hypercapnia) |
Respiratory acidosis
Acute | Chronic |
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Respiratory alkalosis
C | CNS disease (Raised ICP) |
H | Hypoxia (Altitude, anaemia, VQ mismatch) |
A | Anxiety |
M | Mechanical hyperventilation |
P | Progesterone, pregnancy |
S | Sepsis, Salicylates, Other Toxins (nicotine, xanthines) |