Acidosis and Anion Gap

Abstract

The journey of exploring acid and base starts long before, but much advancement was seen in the last century. In 1890, Wilhelm Ostwald electronically measured hydrogen. Svante Arrhenius won the Noble prize in 1903 for the theory of ionization. In 1908, Henderson and Black showed that bicarbonate and phosphate equilibrate with CO 2 at normal body temperature. In 1923, Bronsted first put forward the idea of acid that ionizes in solution and donate hydrogen and the base accepts the hydrogen from the solution. Handerson invented the important bicarbonate buffer system and Hasselbalch First measured the actual blood pH. In 1909, S. P. S. Sorensen developed the pH scale. Later Hasselbalch-Henderson developed an equation that helped in relating pH to the blood bicarbonate and PCO 2. Acidosis has fatal consequences like CNS damage and death. Acidosis is rapidly stabilized by the body buffer systems. There are equal amounts of cations and anions in blood, but some of them are unmeasured. These unmeasured ions are mostly anions that produce an anion gap. Increased anion gap usually represents metabolic acidosis. Albumin and many other confounding factors influence the anion gap derangements. Accuracy in measuring anion gap is critically important for the evaluation of acidosis.