High anion gap metabolic acidosis critical pathways: Difference between revisions

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==Approach==
==Approach==
{| {{table}}
{|CELLPADDING=20 STYLE="WIDTH:50%; HEIGHT:50px" BORDER="1"
| bgcolor=lightyellow |[[Metabolic acidosis physician extender algorithm|Metabolic acidosis physician extender algorithm]]
| BGCOLOR=FLORALWHITE | {{Smallcaps|[[Metabolic acidosis critical pathways|metabolic acidosis critical pathways]]}}
|}
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{| {{table}}
 
| bgcolor=lightyellow |Elevated anion gap?||bgcolor= MediumAquamarine |[[High anion gap metabolic acidosis physician extender algorithm|Yes]]||bgcolor=lightgray |[[Normal anion gap metabolic acidosis physician extender algorithm|No]]
{|CELLPADDING=20 STYLE="WIDTH:50%; HEIGHT:50px" BORDER="1"
| BGCOLOR=FLORALWHITE STYLE="WIDTH:50%"| Anion gap || BGCOLOR=MEDIUMAQUAMARINE STYLE="WIDTH:16.6%" | [[High anion gap metabolic acidosis critical pathways|High]] || BGCOLOR=LIGHTGRAY STYLE="WIDTH:16.6%" | [[Normal anion gap metabolic acidosis critical pathways|Normal]] || BGCOLOR=LIGHTGRAY STYLE="WIDTH:16.6%" | [[Low anion gap metabolic acidosis critical pathways|Low]]
|}
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{| {{table}}
 
| bgcolor=lightyellow |Delta-delta (ΔΔ) value|| bgcolor= lightgray |[[Pure high anion gap metabolic acidosis physician extender algorithm|Equal to 1]]|| bgcolor=lightgray |[[Mixed high anion gap metabolic acidosis with metabolic alkalosis physician extender algorithm|Greater than 1]]|| bgcolor=lightgray |[[Mixed high anion gap metabolic acidosis with normal anion gap metabolic acidosis physician extender algorithm|Less than 1]]
{|CELLPADDING=20 STYLE="WIDTH:50%; HEIGHT:50px" BORDER="1"
| BGCOLOR=FLORALWHITE STYLE="WIDTH:50%"| Delta-delta (ΔΔ) value || BGCOLOR=LIGHTGRAY STYLE="WIDTH:16.6%" | [[High anion gap metabolic acidosis with metabolic alkalosis critical pathways|Greater than 2]] || BGCOLOR=LIGHTGRAY STYLE="WIDTH:16.6%" | [[Pure high anion gap metabolic acidosis critical pathways|Between 1 and 2]] || BGCOLOR=LIGHTGRAY STYLE="WIDTH:16.6%" | [[High anion gap metabolic acidosis with normal anion gap metabolic acidosis critical pathways|Less than 1]]
|}
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* Delta-Delta (ΔΔ) = Delta anion gap (ΔAG) / Delta bicarbonate (ΔHCO3)
* Delta-Delta (ΔΔ) = Delta anion gap (ΔAG) / Delta bicarbonate (ΔHCO3)
** Delta anion gap (ΔAG) = Calculated anion gap - Expected anion gap
** Delta anion gap (ΔAG) = Calculated anion gap - Expected anion gap
*** Calculated anion gap = [Na+] - [Cl-] - [HCO3-]
*** Calculated anion gap = [Na<sup>+</sup>] - [Cl<sup>-</sup>] - [HCO<sub>3</sub><sup>-</sup>]
*** Expected anion gap = 2.5 x serum albumin level
*** Expected anion gap = 2.5 x serum albumin level
** Delta bicarbonate (ΔHCO3) = 24 - serum bicarbonate level
** Delta bicarbonate (ΔHCO<sub>3</sub>) = 24 - serum bicarbonate level


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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[[Category:Critical pathways]]
[[Category:Emergency medicine]]
[[Category:Medicine]]
[[Category:Medicine]]
[[Category:Nephrology]]
[[Category:Nephrology]]
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Latest revision as of 22:10, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Approach

metabolic acidosis critical pathways
Anion gap High Normal Low
Delta-delta (ΔΔ) value Greater than 2 Between 1 and 2 Less than 1

Definition

  • Delta-Delta value is used to determine whether there is an additional metabolic acid-base disturbance or not.
  • Delta-Delta (ΔΔ) = Delta anion gap (ΔAG) / Delta bicarbonate (ΔHCO3)
    • Delta anion gap (ΔAG) = Calculated anion gap - Expected anion gap
      • Calculated anion gap = [Na+] - [Cl-] - [HCO3-]
      • Expected anion gap = 2.5 x serum albumin level
    • Delta bicarbonate (ΔHCO3) = 24 - serum bicarbonate level

References

Template:WikiDoc Sources

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