Wrenn used changes in the anion and bicarbonate gaps to gain insights into acid-base disorders. The author is from Strong Memorial Hospital in Rochester.
Parameters:
(1) delta anion gap (rise in anion gap from baseline)
(2) delta bicarbonate (fall in bicarbonate from baseline)
delta anion gap =
= (current anion gap) - (baseline anion gap)
delta bicarbonate gap =
= (baseline bicarbonate) - (current bicarbonate)
delta gap =
= (delta anion gap) - (delta bicarbonate)
Delta Gap
Consider
> 6
metabolic alkalosis
< -6
hyperchloremic acidosis
NOTE: The derivation of the anion gap includes serum bicarbonate.
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