Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Approach
| Elevated anion gap? |
Yes |
No
|
| Delta-delta (ΔΔ) value |
Equal to 1 |
Higher than 1 |
[High anion gap metabolic acidosis with normal anion gap metabolic acidosis physician extender algorithm|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
References
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