IBCC Episode 56 - NAGMA

In this episode of The Internet Book of Critical Care Podcast, Josh and Adam discuss Non-Anion-Gap Metabolic Acidosis (NAGMA), differentiating it from AGMA and highlighting the importance of the Delta-Delta approach for mixed acid-base disorders. They cover common causes of NAGMA, such as normal saline infusion, resolving DKA, and GI losses, and delve into the complexities of Renal Tubular Acidosis (RTA) types 1, 2, and 4, including their causes and manifestations. The hosts explore the diagnostic approach to NAGMA, emphasizing clinical history, potassium levels, and urine osmolar gap, and conclude by advocating for bicarbonate treatment in most NAGMA cases, while also addressing practical considerations for bicarbonate replacement and potential pitfalls in management.