DDx

Causes: look at Anion Gap (<12)

NAGMA (Due to HCO3 loss) → e.g. Toxic Alohol, Diarrhea

AGMA (Due to H+ gain) → e.g. DKA

Tm

• ID Underlying Mechanism
  • Management
  • De-Toxication
• IV Na CO3 - Sodium Bicarb when pH < 7
  • Temporizing, little evidence except in CKD Patient