How do you interpret the delta-delta ratio?

2.0: high AG acidosis + metabolic alkalosis or pre-existing high bicarb.

What is the clinical importance of delta-delta?

Without delta-delta, a concurrent metabolic alkalosis can mask the degree of acidosis from an AG process, leading to underestimation of severity.

DKA with vomiting, uremia with vomiting, or lactic acidosis with prior bicarb administration are classic combinations.

Calculate delta-delta ratio to identify mixed acid-base disorders in elevated anion gap metabolic acidosis.

Use the full interactive calculator below, or

Anion Gap

Medical

ABG Interpreter

Medical

Bicarb Deficit

Medical

Serum Osmolality

Medical