When do i calculate the delta anion gap?

[rachana]

Here is what I think you are supposed to do for acid-base disorders, PLEASE correct me if I am wrong.

1. Look at pH, HCO3, and PC02 to figure out the primary acid-base disorder (e.g. metabolic acidosis). If met acidosis, calculate anion gap to see if high or normal anion gap.

2. Use Winter's formula and the other chronic/acute resp alk/acidosis relationships to figure out if the compensation is appropriate OR if there a 2nd acid-base disorder present

3. If met acidosis, calculate delta anion gap. If >31, there is a metabolic alkalosis (now we're up to a 3rd disorder). If <21, there is a nonanon gap metabolic acidosis. If between 21 and 31, there is no third acid-base disorder.

PLEASE correct this if I am wrong... I put this together from 3 different sources!! Thanks.

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[4424]

Here is what I think you are supposed to do for acid-base disorders, PLEASE correct me if I am wrong.

1. Look at pH, HCO3, and PC02 to figure out the primary acid-base disorder (e.g. metabolic acidosis). If met acidosis, calculate anion gap to see if high or normal anion gap.

2. Use Winter's formula and the other chronic/acute resp alk/acidosis relationships to figure out if the compensation is appropriate OR if there a 2nd acid-base disorder present

3. If met acidosis, calculate delta anion gap. If >31, there is a metabolic alkalosis (now we're up to a 3rd disorder). If <21, there is a nonanon gap metabolic acidosis. If between 21 and 31, there is no third acid-base disorder.

PLEASE correct this if I am wrong... I put this together from 3 different sources!! Thanks.

that's right. B&W has the same thing plus an example in the end of the Int Medicine part.

 

[Shah_Patel_PT]

Here is what I think you are supposed to do for acid-base disorders, PLEASE correct me if I am wrong.

1. Look at pH, HCO3, and PC02 to figure out the primary acid-base disorder (e.g. metabolic acidosis). If met acidosis, calculate anion gap to see if high or normal anion gap.

2. Use Winter's formula and the other chronic/acute resp alk/acidosis relationships to figure out if the compensation is appropriate OR if there a 2nd acid-base disorder present

3. If met acidosis, calculate delta anion gap. If >31, there is a metabolic alkalosis (now we're up to a 3rd disorder). If <21, there is a nonanon gap metabolic acidosis. If between 21 and 31, there is no third acid-base disorder.

PLEASE correct this if I am wrong... I put this together from 3 different sources!! Thanks.

Remember there is also a delta delta gap.
Diff between the AG and Bicarb Gap...

If the ratio >1 that means there is another primary disorder going...

This is more of Pulmonay ICU stuff...dont know if you need to know it for CK...