Acid-base disorders and strong ion gap.

The application of modern quantitative physical chemical techniques to clinical acid-base has yielded important new information about the nature and clinical significance of metabolic acid-base disorders. Abnormalities identified by the strong ion gap appear to be common in critically ill patients and are associated with increased mortality especially when identified early in the course of critical illness. Attempts to identify the exact chemical nature of ions identified by the strong ion gap have only been of limited success and further study is needed.