Osmolal or Osmolar Gap: Difference between revisions

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==Definitions==
==Definitions==
Osmolarity = the total number of particles in solution per liter
Osmolarity = the total number of particles in solution per liter


Osmolality = the number of particles per kilogram of solvent
Osmolality = the number of particles per kilogram of solvent
== ==


==Background==
==Background==
Serum osmolality should be measured by the freezing-point depression method rather than by the vapor pressure method, since the latter technique will underestimate the concentrations of volatile alcohols (methanol, ethylene glycol, and isopropanol).
Serum osmolality should be measured by the freezing-point depression method rather than by the vapor pressure method, since the latter technique will underestimate the concentrations of volatile alcohols (methanol, ethylene glycol, and isopropanol).


==Calculations==
==Calculations==
===Calculated Osm===
Calculated Osm = 2 x Na = (glu/18) + (BUN/2.8) + (ethanol/4.6) + (methanol/2.6) + (ethylene glycol/5) + (acetone/5.5) + (isopropanol/5.9)


===Osmolal Gap===


Calculated Osm
Osmolal Gap = measured osm - calculated osm
 
2 x Na + (glu/18) + (BUN/2.8) + (ethanol/4.6) +  (methanol/2.6) + (ethylene glycol/5) + (acetone/5.5) + (isopropanol/5.9)
 
 
Osmolal Gap
 
Measured osm - Calculated osm


(Normal = (-)14-10 mOsm/L)
(Normal = (-)14-10 mOsm/L)


===Estimating Toxic Alcohol Concentration===
 
Estimating Toxic Alcohol Concentration


Toxic alcohol (mg/dL) = Osmolal gap x Conversion Factor
Toxic alcohol (mg/dL) = Osmolal gap x Conversion Factor


^Parent compounds are responsible for the osmolar gap while their metabolites are responsible for anion gap changes
 
 
 
*Parent compounds are responsible for the osmolar gap while their metabolites are responsible for anion gap changes
 
 
==DDX (Increased)==
 
 
Alcohols
 
    -ethanol
 
    -methanol
 
    -ethylene glycol
 
    -isopropanol
 
Sugar
 
    -glycerol
 
    -mannitol
 
Ketones
 
    -acetone
 
Other
 
    -propylene glycol
 
    -osmotic contrast dyes
 
 


==DDX==
===Increased)===
#Alcohols
##methanol
##ethylene glycol
##isopropanol
#Sugar
##glycerol
##manitol
#Ketones
##acetone


[[Category:FEN]]
[[Category:FEN]]

Revision as of 05:20, 14 March 2011

Definitions

Osmolarity = the total number of particles in solution per liter

Osmolality = the number of particles per kilogram of solvent

Background

Serum osmolality should be measured by the freezing-point depression method rather than by the vapor pressure method, since the latter technique will underestimate the concentrations of volatile alcohols (methanol, ethylene glycol, and isopropanol).

Calculations

Calculated Osm

Calculated Osm = 2 x Na = (glu/18) + (BUN/2.8) + (ethanol/4.6) + (methanol/2.6) + (ethylene glycol/5) + (acetone/5.5) + (isopropanol/5.9)

Osmolal Gap

Osmolal Gap = measured osm - calculated osm

(Normal = (-)14-10 mOsm/L)

Estimating Toxic Alcohol Concentration

Toxic alcohol (mg/dL) = Osmolal gap x Conversion Factor

^Parent compounds are responsible for the osmolar gap while their metabolites are responsible for anion gap changes

DDX

Increased)

  1. Alcohols
    1. methanol
    2. ethylene glycol
    3. isopropanol
  2. Sugar
    1. glycerol
    2. manitol
  3. Ketones
    1. acetone