Table 4.

Electrolytes in typical patients with lactic acidosis and varying baseline serum anion gaps assuming 1:1 relationship between ΔAG/ΔHCO3

Blood Chemistries (mEq/L)Patient 1Patient 2
BaselineMild Lactic AcidosisModerate Lactic AcidosisMore Severe Lactic AcidosisBaselineMild Lactic AcidosisMore Severe Lactic Acidosis
Na+140140140140140140140
K+3.53.53.53.53.53.53.5
Cl113113113113106106106
HCO324211815242118
Anion gap36912101316
ΔAG36936
Lactate12.56812.56
Acid-base interpretationNo anion gap acidosisNormal anion gap acidosisHigh anion gap acidosisHigh anion gap acidosisHigh anion gap acidosis
  • Of course, as explained in the text, the ΔAG/ΔHCO3 often exceeds 1:1 with lactic acidosis. The hypothetical patients shown in the table are meant to emphasize the point that in some cases a relatively high serum lactate concentration will need to be present to cause the anion gap to rise outside the normal range. ΔAG, change in anion gap