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Related Experiment Videos

Serum osmolality in acute intoxication: a prospective clinical study.

A A Pappas, R H Gadsden, E H Taylor

    American Journal of Clinical Pathology
    |July 1, 1985
    PubMed
    Summary

    This study shows that measuring serum delta osmolality alongside alcohol dehydrogenase can quickly and accurately detect ethanol and other volatiles in intoxicated patients. The combined delta-Osm/ADH method is highly sensitive and specific for identifying these substances.

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    Area of Science:

    • Toxicology
    • Clinical Chemistry
    • Emergency Medicine

    Background:

    • Accurate and rapid detection of ethanol and other volatile substances is crucial in managing acutely intoxicated patients.
    • Existing methods may have limitations in speed or availability for simultaneous assessment.

    Purpose of the Study:

    • To evaluate the clinical utility of a combined delta-osmolality (delta-Osm) and alcohol dehydrogenase (ADH) assay for detecting ethanol (EtOH) and other low molecular weight volatiles in acutely intoxicated individuals.
    • To establish reference ranges for serum osmolality in a healthy population.

    Main Methods:

    • Prospective analysis of serum delta-Osm, ADH-quantified serum EtOH, and urine drug screens in 339 intoxicated patients.
    • Establishment of reference serum osmolality ranges in 55 healthy volunteers.

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  • Comparison of delta-Osm/ADH results with head-space gas chromatography (GC-HS) for volatile identification.

    • Main Results:

    • High correlation (0.968) between delta-Osm and serum EtOH in patients with detected EtOH.
    • The delta-Osm/ADH method demonstrated high sensitivity (98.1%) and specificity (98.2%) for EtOH detection.
    • The assay accurately identified EtOH and other volatiles with minimal false positives/negatives, unaffected by other drugs.

    Conclusions:

    • The combined delta-Osm/ADH procedure is an efficient, rapid, and accessible method for evaluating acutely intoxicated patients.
    • This method reliably detects ethanol and other low molecular weight volatiles, aiding in clinical management.
    • The assay shows excellent diagnostic performance for ethanol detection in overdose scenarios.