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Use the Measured Sodium Concentration!
- During a recent shift, a question arose regarding whether to use the measured or corrected sodium to calculate the anion gap in a critically ill patient with DKA.
- Recall that the anion gap provides an estimation of unmeasured anions - in this case acetoacetate and beta-hydroxybutyrate.
- Glucose is electrically neutral and therefore does not affect the anion gap.
- When calculating the anion gap in a patient with DKA, use the actual (measured) serum Na, rather than the corrected value.
References
Beck, L. Cleveland Clin J Med 2001;68:673.