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Commentary

Unmeasured anions: the unknown unknowns

Bala Venkatesh1* and Thomas J Morgan2

Author Affiliations

1 Department of Intensive Care, Princess Alexandra and Wesley Hospitals, University of Queensland, Queensland, QLD 4102, Australia

2 Department of Intensive Care, Mater Misericordiae Hospital, South Brisbane, Queensland, QLD 4101, Australia

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Critical Care 2008, 12:113 doi:10.1186/cc6768

Published: 5 February 2008

Abstract

Evidence is emerging that elevated concentrations of the intermediates of the citric acid cycle may contribute to unmeasured anions in critical illness. Both the anion gap and the strong ion gap are used as scanning tools for recognition of these anions. The mechanisms underlying these elevations and their significance require further clarification.