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VOLUME 26 , ISSUE 12 ( December, 2022 ) > List of Articles


Normal Anion Gap Metabolic Acidosis in Pediatric Acute Diarrhea: A Menace or an Innocent Bystander?

Rohit Bhowmick

Keywords : Acidosis, Metabolic Acidosis, Non-anion-gap metabolic acidosis, Severe dehydration

Citation Information : Bhowmick R. Normal Anion Gap Metabolic Acidosis in Pediatric Acute Diarrhea: A Menace or an Innocent Bystander?. Indian J Crit Care Med 2022; 26 (12):1235-1236.

DOI: 10.5005/jp-journals-10071-24371

License: CC BY-NC 4.0

Published Online: 08-12-2022

Copyright Statement:  Copyright © 2022; The Author(s).


  1. Chisti MJ, Pietroni MAC, Smith JH, Bardhan PK, Salam MA. Predictors of death in under-five children with diarrhoea admitted to a critical care ward in an urban hospital in Bangladesh. Acta Paediatr 2011;100(12):e275–e279. DOI: 10.1111/j.1651-2227.2011.02368.x.
  2. Alam T, Ahmed T, Sarmin M, Shahrin L, Afroze F, Sharifuzzaman M, et al. Risk factors for death in Bangladeshi children under 5 years of age hospitalized for diarrhea and severe respiratory distress in an urban critical care ward. Glob Pediatr Health 2017;4:2333794X17696685. DOI: 10.1177/2333794X17696685.
  3. Singh M, Sankar J, Kumar A, Kumar UV, Lodha R, Kabra SK. Predictors of mortality in children admitted to the pediatric intensive care unit with acute gastroenteritis with severe dehydration. Indian J Pediatr 2019;86(12):1142–1145. DOI: 10.1007/s12098-019-03094-0.
  4. Chisti MJ, Ahmed T, Ashraf H, Faruque ASG, Bardhan PK, Dey SK, et al. Clinical predictors and outcome of metabolic acidosis in under-five children admitted to an urban hospital in Bangladesh with diarrhea and pneumonia. PLoS One 2012;7(6):e39164. DOI: 10.1371/journal.pone.0039164.
  5. Eke C, Ndu I, Edelu B, Uleanya N, Ekwochi U, Chinawa J, et al. Clinical profile and electrolyte abnormalities in hospitalized under-five children with acute gastroenteritis in a tertiary health facility. Niger J Med 2020;29(2):295. DOI: 10.4103/NJM.NJM_64_20.
  6. Akech S, Ayieko P, Gathara D, Agweyu A, Irimu G, Stepniewska K, et al. Risk factors for mortality and effect of correct fluid prescription in children with diarrhoea and dehydration without severe acute malnutrition admitted to Kenyan hospitals: an observational, association study. Lancet Child Adolesc Health 2018;2(7):516–524. DOI: 10.1016/S2352-4642(18)30130-5.
  7. Kraut JA, Madias NE. Treatment of acute metabolic acidosis: A pathophysiologic approach. Nat Rev Nephrol 2012;8(10):589–601. DOI: 10.1038/nrneph.2012.186.
  8. Kimia AA, Johnston P, Capraro A, Harper MB. Occurrence of metabolic acidosis in pediatric emergency department patients as a data source for disease surveillance systems. Pediatr Emerg Care. 2010;26(10): 733–738. DOI: 10.1097/PEC.0b013e3181f395f4.
  9. Morooka H, Kasugai D, Tanaka A, Ozaki M, Numaguchi A, Maruyama S. Prognostic impact of parameters of metabolic acidosis in critically ill children with acute kidney injury: A retrospective observational analysis using the PIC database. Diagnostics (Basel) 2020;10(11):937. DOI: 10.3390/diagnostics10110937.
  10. Paul M, Partridge J, Barrett–Reis B, Ahmad KA, Machiraju P, Jayapalan H, et al. Metabolic acidosis in preterm infants is associated with a longer length of stay in the neonatal intensive care unit. Pharmacoecon Open 2020;4(3):541–547. DOI: 10.1007/s41669-020-00194-y.
  11. Kim MJ, Kim YH, Sol IS, Kim SY, Kim JD, Kim HY, et al. Serum anion gap at admission as a predictor of mortality in the pediatric intensive care unit. Sci Rep 2017;7(1):1456. DOI: 10.1038/s41598-017-01681-9.
  12. Loomba RS, Abdulkarim M, Bronicki RA, Villarreal EG, Flores S. Impact of sodium bicarbonate therapy on hemodynamic parameters in infants: A meta-analysis. J Matern Fetal Neonatal Med 2022;35(12):2324–2330. DOI: 10.1080/14767058.2020.1786051.
  13. Chowdhury AH, Cox EF, Francis ST, Lobo DN. A randomized, controlled, double-blind crossover study on the effects of 2-L infusions of 0.9% saline and plasma-lyte® 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers. Ann Surg 2012;256(1):18–24. DOI: 10.1097/SLA.0b013e318256be72.
  14. Stenson EK, Cvijanovich NZ, Anas N, Allen GL, Thomas NJ, Bigham MT, et al. Hyperchloremia is associated with complicated course and mortality in pediatric patients with septic shock. Pediatr Crit Care Med 2018;19(2):155–160. DOI: 10.1097/PCC.0000000000001401.
  15. Takia L, Baranwal AK, Gupta PK, Angurana SK, Jayashree M. Acute Diarrhea and Severe Dehydration in Children: Does Non-anion-gap Component of Severe Metabolic Acidemia Need More Attention? Indian J Crit Care Med 2022;26(12):1300–1307.
  16. Jung B, Martinez M, Claessens YE, Darmon M, Klouche K, Lautrette A, et al. Diagnosis and management of metabolic acidosis: Guidelines from a French expert panel. Ann Intensive Care 2019;9(1):92. DOI: 10.1186/s13613-019-0563-2.
  17. Wang H, Liang R, Liang T, Chen S, Zhang Y, Zhang L, et al. Effectiveness of sodium bicarbonate infusion on mortality in critically ill children with metabolic acidosis. Front Pharmacol 2022;13:759247. DOI: 10.3389/fphar.2022.759247.
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