Standard base excess cBase(Ecf)

cBase(ecf) = 16.2 × (pH - 7.40) - 24.8 + cHCO3-.

cBase(B,oxygenated) = cBase(B,actual) - 0.2 × ctHb × (1 - sO2)

actual base excess: cBase(B)c.

ctH+", or the concentration of titratable hydrogen ions

The Van Slyke Equation: 24.4 = - (2.3 ± b + 7.7) ± (c - 7.40) + d/(1 - 0.023 ± b),

Delta Ratio
Delta Ratio = the increase in Anion Gap / the decrease in HCO3-

can check delta ratio in the presence of a high anion gap metabolic acidosis (HAGMA) to
determine if it is a ‘pure’ HAGMA or if there is coexistant normal anion gap metabolic acidosis
(NAGMA) or metabolic alkalosis

< 0.4

 hyperchloraemic normal anion gap metabolic acidosis (NAGMA)

0.4 – 0.8

 consider combined HAGMA + NAGMA, BUT note that the ratio is often < 1 in acidosis
associated with renal failure
1–2

 usual for uncomplicated HAGMA.

>2

 a high delta ratio can occur in the situation where the patient had quite an elevated
bicarbonate value at the onset of the metabolic acidosis.
 A-a Gradient (at sea level)
o A-a Gradient = FIO2 x (760 - 47) - (1.2 * PaCO2) - PaO2
o FIO2 on room air = 0.21
 A-a Gradient on room air (FIO2 0.21)
o A-a Gradient = 150 - (1.2 * PaCO2) - PaO2
Corrected Sodium= Measured sodium + glucose/4