Calculating the ratio of the change in the anion gap (Δ anion gap) to the change in bicarbonate level (Δ bicarbonate), or the “Δ-Δ ratio,” can help confirm if there is a coexisting acid-base disturbance. A ratio of <1 may reflect the presence of concurrent normal anion gap metabolic acidosis, whereas a ratio of >2 may indicate the presence of metabolic alkalosis
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ELBOMBARDO - (no access) - MKSAP_17.pdf, p3544
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