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Blood Gas Acid-Base Interpretation (AG / ΔAG)

· Last updated：2026-08-10

This tool is for informational purposes only and does not constitute medical, financial, or legal advice; consult a qualified professional for advice.

Complete ABG analysis: pH, primary disorder, compensation (Winter's formula), anion gap ± albumin correction, delta ratio for mixed disorder detection. Derived from Emmett 2016, Kraut 2007, Rastegar 2007, LITFL, MDCalc, and Adrogué 1998. Not medical advice.

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Written by the Elysia Tools team

Tool usage guide

Learn when to use this tool, what it supports, and how real users apply it.

Key facts

Category
Health
Input types
number
Output type
json
Sample coverage
4
API ready
Yes

Overview

Blood Gas Acid-Base Interpretation analyzes arterial pH, PaCO₂, HCO₃⁻, sodium, and chloride to identify the primary acid-base disorder, assess compensation with Winter’s formula, calculate the anion gap, and use the delta ratio to flag possible mixed disorders. Albumin can be added for anion gap correction. This tool is not medical advice.

When to use

  • Interpret an arterial blood gas together with basic electrolyte values.
  • Check whether respiratory compensation is appropriate for metabolic acidosis.
  • Assess for high anion gap metabolic acidosis and possible mixed acid-base disorders.

How it works

  1. 1Enter pH, PaCO₂, HCO₃⁻, sodium, and chloride; optionally enter albumin for anion gap correction.
  2. 2The tool classifies pH and identifies the primary metabolic or respiratory disorder.
  3. 3For metabolic acidosis, it compares measured PaCO₂ with the expected value from Winter’s formula.
  4. 4It calculates the anion gap and delta ratio, then returns a structured JSON interpretation.

Use cases

  • Bedside review of acid-base status in critical care and emergency settings.
  • Evaluation of suspected lactic acidosis or diabetic ketoacidosis alongside clinical findings.
  • Nephrology teaching and case review involving anion gap and mixed acid-base disorders.

Examples

1. High anion gap metabolic acidosis with appropriate compensation

Critical care clinician

Background

A patient has acidemia with a low bicarbonate and reduced PaCO₂.

Problem

Determine whether the findings represent high anion gap metabolic acidosis and whether respiratory compensation is appropriate.

How to use

Enter pH 7.20, PaCO₂ 25 mmHg, HCO₃⁻ 10 mmol/L, sodium 140 mmol/L, chloride 104 mmol/L, albumin 4.0 g/dL, and select 1 decimal place.

{"ph":7.2,"paco2":25,"hco3":10,"sodium":140,"chloride":104,"albumin":4,"decimalPlaces":1}

Outcome

The tool calculates an anion gap of 26, identifies high anion gap metabolic acidosis, and reports appropriate respiratory compensation by Winter’s formula. The delta ratio is 1.0, consistent with a pure high anion gap metabolic acidosis.

2. Reviewing a possible mixed acid-base pattern

Nephrology trainee

Background

A patient has acidemia, low bicarbonate, and a high anion gap.

Problem

Use compensation and delta-ratio results to check for additional respiratory or metabolic abnormalities.

How to use

FAQ

What inputs are required?

Enter pH, PaCO₂, HCO₃⁻, sodium, and chloride. Albumin is optional.

What is the anion gap formula?

The tool calculates anion gap as Na⁺ − Cl⁻ − HCO₃⁻.

What does Winter’s formula assess?

It estimates the expected PaCO₂ during metabolic acidosis to assess respiratory compensation.

What does the delta ratio indicate?

The delta ratio helps distinguish a relatively pure high anion gap metabolic acidosis from possible mixed metabolic disorders.

Can albumin be left blank?

Yes. Albumin is optional and can be omitted when it is unavailable.

Hub

Critical Care Blood Gas, Oxygenation, and Hemodynamics Workflow

Connect ABG acid-base interpretation with oxygenation, cardiac output, and vascular resistance calculations for structured clinical checking.

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Enter pH 7.25, PaCO₂ 30 mmHg, HCO₃⁻ 13 mmol/L, sodium 140 mmol/L, chloride 100 mmol/L, leave albumin blank, and select 1 decimal place.

{"ph":7.25,"paco2":30,"hco3":13,"sodium":140,"chloride":100,"decimalPlaces":1}

Outcome

The tool calculates an anion gap of 27 and a delta ratio of about 1.36, consistent with high anion gap metabolic acidosis. Winter’s expected PaCO₂ is about 27.5 ± 2 mmHg; the measured value is slightly higher.