High anion gap metabolic acidosis critical pathways: Difference between revisions

Revision as of 20:48, 1 August 2013

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

Elevated anion gap?

Delta-delta (ΔΔ) value

[High anion gap metabolic acidosis with normal anion gap metabolic acidosis physician extender algorithm|Lower than 1]]

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

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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|Higher than 1]]|| bgcolor=lightgray |[[Mixed high anion gap metabolic acidosis with normal anion gap metabolic acidosis physician extender algorithm|Lower than 1]]
+| bgcolor=lightyellow |Delta-delta (ΔΔ) value|| bgcolor= lightgray |[[High anion gap metabolic acidosis physician extender algorithm|Equal to 1]]|| bgcolor=lightgray |[[High anion gap metabolic acidosis with metabolic alkalosis physician extender algorithm|Higher than 1]]|| bgcolor=lightgray |[High anion gap metabolic acidosis with normal anion gap metabolic acidosis physician extender algorithm|Lower than 1]]
 |}