if approached in a consistent manner. The pH, PaC02, and 1 should be inspected to identify all abnormal values. This should lead to an assessment of which deviations represent the primary abnormality and which represent compensatory changes. The serum electrolytes should always be used to calculate the anion gap. In cases in which the anion gap is increased, the excess anion gap should be added i iro~

back to the measured 1 3 . The anion gap and the excess gap are useful tools that can identify hidden disorders. This rigorous assessment of the patient's acid-base status, incorporated with the available clinical data, increases the likelihood that the clinician will successfully determine the cause of each identified disorder. Although supportive therapy is often required for profound acid-base disturbances, definitive therapy must target the underlying process that has led to the observed derangements.

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