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Related Experiment Videos

Osmol gaps revisited: normal values and limitations

R S Hoffman1, M J Smilkstein, M A Howland

  • 1New York City Poison Control Center, NY 10016.

Journal of Toxicology. Clinical Toxicology
|January 1, 1993
PubMed
Summary
This summary is machine-generated.

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The osmol gap calculation varies significantly based on the equation used. Small osmol gaps should not rule out toxic alcohol ingestion, as results depend heavily on chosen formulas.

Area of Science:

  • Clinical Chemistry
  • Toxicology
  • Internal Medicine

Background:

  • The osmol gap is a calculated difference between measured and estimated serum osmolarity.
  • Accurate osmol gap calculation is crucial for diagnosing conditions like toxic alcohol ingestion.
  • Existing equations for osmolarity calculation may not be universally applicable.

Purpose of the Study:

  • To define the osmol gap in patients with known serum ethanol levels.
  • To reevaluate and compare different equations for calculating osmolarity.
  • To assess the clinical utility of the osmol gap in suspected toxic alcohol ingestions.

Main Methods:

  • Prospective enrollment of adult patients requiring serum ethanol and electrolyte determination.
  • Exclusion of 16 patients from the final analysis of 321 enrolled.

Related Experiment Videos

  • Stepwise multiple linear regression to determine optimal coefficients for sodium, blood urea nitrogen, and ethanol.

    • Main Results:

    • The calculated osmol gap was -2 +/- 6 mOsm using a specific regression-derived formula.
    • Different osmolarity equations yielded varying osmol gap values, ranging from -5 to +15 mOsm.
    • Standard deviations and correlation coefficients were comparable across different calculation methods.

    Conclusions:

    • Significant variability exists in osmol gap values depending on the calculation formula employed.
    • Absolute osmol gap values are highly dependent on the specific osmolarity equation used.
    • Small osmol gaps should not be relied upon to exclude the possibility of toxic alcohol ingestion due to equation-dependent variations.