High anion gap metabolic acidosis critical pathways: Difference between revisions
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Revision as of 20:44, 1 August 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Approach
| Metabolic acidosis physician extender algorithm |
| Elevated anion gap? | Yes | No |
| Delta-delta (ΔΔ) value | Equal to 1 | Higher than 1 | Lower 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
- Delta anion gap (ΔAG) = Calculated anion gap - Expected anion gap