When managing patients with AG Metabolic Acidosis:
A CAT PILES MUD can help broaden your differential
A - Acetaminophen
C - CO, CN
A - AKA, Starvation ketoacidosis
T - Toluene
P - Paraldehyde, phenformin, propylene glycol
I - Isoniazid, Iron, Ibuprofen, Ischemia
L - Lactate elevation
E - Ethanol, Ethylene glycol
S - Salicylates
M - Methanol, Metformin
U - Uremia
D - DKA
- Same general resuscitation principles apply
- Watch your patient’s respiratory rate
- Broaden your differential for unknown source of acidosis
- Don’t just get sucked into thinking this is sepsis
- Realize you may have to start multiple antidotes initially while you rule things out
A CAT PILES MUD can help broaden your differential
A - Acetaminophen
C - CO, CN
A - AKA, Starvation ketoacidosis
T - Toluene
P - Paraldehyde, phenformin, propylene glycol
I - Isoniazid, Iron, Ibuprofen, Ischemia
L - Lactate elevation
E - Ethanol, Ethylene glycol
S - Salicylates
M - Methanol, Metformin
U - Uremia
D - DKA