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Plasma osmolality

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355:. Even though these values are presented in different units, when there is a small amount of solute compared to total volume of solution, the absolute values of osmolality vs. osmolarity are very close. Often, this results in confusion as to which units are meant. For practical purposes, the units are considered interchangeable. The resulting "osmolar gap" can be thought of as either osmolar or osmolal, since both units have been used in its derivation. 346:
is the difference between the measured osmolality and the calculated osmolarity. The difference in units is attributed to the difference in the way that blood solutes are measured in the laboratory versus the way they are calculated. The laboratory value measures the freezing point depression,
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used for osmolality) excludes the weight of any solutes, whereas the total solution volume (used for osmolarity) includes solute content. Otherwise, one litre of plasma would be equivalent to one kilogram of plasma, and plasma osmolarity and plasma osmolality would be equal. However, at low
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Plasma osmolarity of some reptiles, especial those from a freshwater aquatic environment, may be lower than that of mammals (e.g. < 260 mOsm/L) during favourable conditions. Consequently, solutions osmotically balanced for mammals (e.g., 0.9% normal saline) are likely to be mildly
237:(ICF). Therefore, plasma osmolality is a guide to intracellular osmolality. This is important, as it shows that changes in ECF osmolality have a great effect on ICF osmolality — changes that can cause problems with normal cell functioning and volume. If the ECF were to become too 175:. In practice, there is almost negligible difference between the absolute values of the different measurements. For this reason, both terms are often used interchangeably, even though they refer to different units of measurement. 212:
Deep-sea fish have adapted to the extreme hydrostatic pressures of depth through a number of factors, including increasing osmolality, with one of the deepest known fish in the world, the hadal snailfish
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Clinically, the osmolar gap is used to detect the presence of an osmotically active particle that is not normally found in plasma, usually a toxic alcohol such as ethanol, methanol or isopropyl alcohol.
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having a recorded muscle osmolality of 991 ± 22 mOsmol/kg, almost four times the osmolality of mammals and three times that of shallow water fish species (typically 350 mOsmol/kg).
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Osmolarity is affected by changes in water content, as well as temperature and pressure. In contrast, osmolality is independent of temperature and pressure. For a given solution,
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Purssell RA, Pudek M, Brubacher J, Abu-Laban RB (December 2001). "Derivation and validation of a formula to calculate the contribution of ethanol to the osmolal gap".
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occurs when excessive release of antidiuretic hormone results in inappropriately elevated urine osmolality (>100 mOsmol/L) relative to the blood plasma, leading to
268:, and less concentrated blood plasma. A low serum osmolality will suppress the release of ADH, resulting in decreased water reabsorption and more concentrated plasma. 747: 297:
In medical lab reports, this quantity often appears as "Osmo, Calc" or "Osmo (Calc)." According to the international SI unit use the following equation :
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concentrations (below about 500 mM), the mass of the solute is negligible compared to the mass of the solvent, and osmolarity and osmolality are very similar.
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are measures that are technically different, but functionally the same for normal use. Whereas osmolality (with an "l") is defined as the number of
249:). Many poisons, medications and diseases affect the balance between the ICF and ECF, affecting individual cells and homeostasis as a whole. 326:
Based on the molecular weight of ethanol the divisor should be 4.6 but empiric data shows that ethanol does not behave as an ideal osmole.
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As Na+ is the major extracellular cation, the sum of osmolarity of all other anions can be assumed to be equal to natremia, hence x2 ≈ +
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Measured osmolality is abbreviated "MO", calculated osmolarity is abbreviated "CO", and the osmolality gap is abbreviated "OG".
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Hannon MJ, Thompson CJ (June 2010). "The syndrome of inappropriate antidiuretic hormone: prevalence, causes and consequences".
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and decreases with overhydration. In normal people, increased osmolality in the blood will stimulate secretion of
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species allow major elevations of plasma osmolarity (e.g. > 400 mOsm/L) that could be fatal to some mammals.
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Bhalla A, Sankaralingam S, Dundas R, Swaminathan R, Wolfe CD, Rudd AG (September 2000).
495: 1171: 1027: 800: 790: 522: 480:"Marine fish may be biochemically constrained from inhabiting the deepest ocean depths" 479: 134: 80: 241:, water would readily fill surrounding cells, increasing their volume and potentially 1305: 1214: 1193: 1107: 1032: 965: 381: 226: 48: 732: 1219: 1188: 1091: 992: 780: 603: 275: 660: 435: 1037: 997: 977: 912: 874: 865: 860: 855: 772: 257: 484:
Proceedings of the National Academy of Sciences of the United States of America
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To calculate plasma osmolality use the following equation (typical in the US):
957: 897: 884: 805: 764: 619:"Influence of raised plasma osmolality on clinical outcome after acute stroke" 352: 348: 206: 172: 168: 92: 44: 644: 587: 545: 513: 418: 1129: 1124: 1119: 1047: 845: 690: 504: 342: 335: 246: 138: 130: 76: 698: 652: 595: 531: 444: 264:(ADH). This will result in increased water reabsorption, more concentrated 458: 1209: 1141: 892: 238: 202: 52: 40: 579: 478:
Yancey PH, Gerringer ME, Drazen JC, Rowden AA, Jamieson A (2014-03-25).
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is slightly less than osmolality, because the total solvent weight (the
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derived from lab data that were measured in solutions (Na, Glu, Urea)
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of osmolality in plasma is about 275-299 milli-osmoles per kilogram.
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Osmolality can be measured on an analytical instrument called an
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in general are freely permeable to water, the osmolality of the
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for such animals. Many arid species of reptiles and hibernating
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Calculated osmolarity = 2 Na + Glucose + Urea (all in mmol/L)
278:. This ADH secretion may occur in excessive amounts from the 419:"Osmolality and osmolarity: narrowing the terminology gap" 167:
Therefore, bedside calculations are actually in units of
1279: 1239: 1232: 1202: 1179: 1170: 1140: 1061: 1018: 956: 926: 883: 836: 771: 310:= 2 + /18 + /2.8 where and are measured in mg/dL. 289:Elevation may be associated with stroke mortality. 103:Technically, the terms can be compared as follows: 23: 713:"Osmolality Gap - Calculation and Interpretation" 351:while the calculated value is given in units of 672: 670: 748: 8: 233:(ECF) is approximately equal to that of the 1236: 1176: 755: 741: 733: 79:. It works on the method of depression of 634: 521: 503: 434: 105: 392: 272:Syndrome of inappropriate ADH secretion 20: 7: 1053:Glycogen phosphorylase isoenzyme BB 282:, or from ectopic sources such as 14: 568:European Journal of Endocrinology 284:small-cell carcinoma of the lung 459:"Case 422 —Neuropathology Case" 382:Serum Osmolarity vs. Osmolality 1: 1010:Comprehensive metabolic panel 436:10.1592/phco.23.10.1085.32751 546:"Serum and Urine Osmolality" 417:Erstad BL (September 2003). 314:If the patient has ingested 87:Osmolality versus osmolarity 946:Thyroid-stimulating hormone 908:Total iron-binding capacity 1328: 1287:Elevated alpha-fetoprotein 333: 293:Calculated osmolarity (CO) 215:Notoliparis kermadecensis) 280:posterior pituitary gland 128:freezing point depression 35:electrolyte–water balance 645:10.1161/01.str.31.9.2043 71:Measured osmolality (MO) 816:BUN-to-creatinine ratio 691:10.1067/mem.2001.119455 505:10.1073/pnas.1322003111 322:= 2 + /18 + /2.8 + /3.7 1249:Elevated transaminases 941:Thyroid function tests 903:Transferrin saturation 763:Clinical biochemistry 407:, accessed 2012-01-11. 123:clinical laboratories 1043:Lactate dehydrogenase 1005:Basic metabolic panel 936:ACTH stimulation test 372:Osmotic concentration 152:bedside calculations 1063:Liver function tests 918:Transferrin receptor 262:antidiuretic hormone 51:(Osm) of solute per 33:measures the body's 1079:Serum total protein 1074:Human serum albumin 580:10.1530/eje-09-1063 496:2014PNAS..111.4461Y 235:intracellular fluid 231:extracellular fluid 851:Arterial blood gas 574:(Suppl1): S5–S12. 221:Clinical relevance 1299: 1298: 1295: 1294: 1228: 1227: 1181:Blood sugar level 1160:Pancreatic lipase 998:Total cholesterol 828:Serum osmolal gap 823:Plasma osmolality 490:(12): 4461–4465. 165: 164: 115:Appropriate term 31:Plasma osmolality 28: 27: 24:Plasma osmolality 1319: 1271:Hyperproteinemia 1237: 1177: 757: 750: 743: 734: 728: 727: 725: 724: 715:. Archived from 709: 703: 702: 674: 665: 664: 638: 614: 608: 607: 563: 557: 556: 554: 553: 542: 536: 535: 525: 507: 475: 469: 468: 466: 465: 455: 449: 448: 438: 414: 408: 405:Lab Tests Online 397: 377:Urine osmolality 347:properly called 330:Osmolar gap (OG) 106: 21: 1327: 1326: 1322: 1321: 1320: 1318: 1317: 1316: 1302: 1301: 1300: 1291: 1275: 1264:Hypoalbuminemia 1259:Hypoproteinemia 1224: 1198: 1172:Small molecules 1166: 1136: 1057: 1014: 952: 922: 879: 869: 832: 767: 761: 731: 722: 720: 711: 710: 706: 676: 675: 668: 616: 615: 611: 565: 564: 560: 551: 549: 544: 543: 539: 477: 476: 472: 463: 461: 457: 456: 452: 423:Pharmacotherapy 416: 415: 411: 398: 394: 390: 368: 338: 332: 295: 256:increases with 223: 198: 190:reference range 186: 181: 89: 73: 17: 12: 11: 5: 1325: 1323: 1315: 1314: 1304: 1303: 1297: 1296: 1293: 1292: 1290: 1289: 1283: 1281: 1277: 1276: 1274: 1273: 1268: 1267: 1266: 1256: 1251: 1245: 1243: 1234: 1230: 1229: 1226: 1225: 1223: 1222: 1217: 1212: 1206: 1204: 1200: 1199: 1197: 1196: 1191: 1185: 1183: 1174: 1168: 1167: 1165: 1164: 1163: 1162: 1152: 1146: 1144: 1138: 1137: 1135: 1134: 1133: 1132: 1127: 1117: 1112: 1111: 1110: 1105: 1100: 1088: 1083: 1082: 1081: 1076: 1067: 1065: 1059: 1058: 1056: 1055: 1050: 1045: 1040: 1035: 1030: 1028:Cardiac marker 1024: 1022: 1020:Cardiovascular 1016: 1015: 1013: 1012: 1007: 1002: 1001: 1000: 995: 990: 985: 975: 974: 973: 971:Hemoglobin A1c 962: 960: 954: 953: 951: 950: 949: 948: 938: 932: 930: 924: 923: 921: 920: 915: 910: 905: 900: 895: 889: 887: 881: 880: 878: 877: 872: 867: 863: 858: 853: 848: 842: 840: 834: 833: 831: 830: 825: 820: 819: 818: 813: 808: 801:Renal function 798: 793: 788: 783: 777: 775: 769: 768: 762: 760: 759: 752: 745: 737: 730: 729: 704: 666: 636:10.1.1.510.254 609: 558: 537: 470: 450: 409: 391: 389: 386: 385: 384: 379: 374: 367: 364: 334:Main article: 331: 328: 324: 323: 312: 311: 294: 291: 252:Osmolality of 227:cell membranes 222: 219: 197: 194: 185: 182: 180: 177: 163: 162: 159: 156: 153: 149: 148: 145: 142: 135:vapor pressure 124: 120: 119: 116: 113: 110: 88: 85: 81:freezing point 72: 69: 26: 25: 15: 13: 10: 9: 6: 4: 3: 2: 1324: 1313: 1310: 1309: 1307: 1288: 1285: 1284: 1282: 1278: 1272: 1269: 1265: 1262: 1261: 1260: 1257: 1255: 1252: 1250: 1247: 1246: 1244: 1242: 1238: 1235: 1231: 1221: 1218: 1216: 1215:Hyperuricemia 1213: 1211: 1208: 1207: 1205: 1201: 1195: 1194:Hyperglycemia 1192: 1190: 1187: 1186: 1184: 1182: 1178: 1175: 1173: 1169: 1161: 1158: 1157: 1156: 1153: 1151: 1148: 1147: 1145: 1143: 1139: 1131: 1128: 1126: 1123: 1122: 1121: 1118: 1116: 1113: 1109: 1108:AST/ALT ratio 1106: 1104: 1101: 1099: 1096: 1095: 1094: 1093: 1092:transaminases 1089: 1087: 1084: 1080: 1077: 1075: 1072: 1071: 1069: 1068: 1066: 1064: 1060: 1054: 1051: 1049: 1046: 1044: 1041: 1039: 1036: 1034: 1033:Troponin test 1031: 1029: 1026: 1025: 1023: 1021: 1017: 1011: 1008: 1006: 1003: 999: 996: 994: 993:Triglycerides 991: 989: 986: 984: 981: 980: 979: 976: 972: 969: 968: 967: 966:Blood glucose 964: 963: 961: 959: 955: 947: 944: 943: 942: 939: 937: 934: 933: 931: 929: 925: 919: 916: 914: 911: 909: 906: 904: 901: 899: 896: 894: 891: 890: 888: 886: 882: 876: 873: 871: 864: 862: 859: 857: 854: 852: 849: 847: 844: 843: 841: 839: 835: 829: 826: 824: 821: 817: 814: 812: 809: 807: 804: 803: 802: 799: 797: 794: 792: 789: 787: 784: 782: 779: 778: 776: 774: 770: 766: 758: 753: 751: 746: 744: 739: 738: 735: 719:on 2009-08-04 718: 714: 708: 705: 700: 696: 692: 688: 684: 680: 679:Ann Emerg Med 673: 671: 667: 662: 658: 654: 650: 646: 642: 637: 632: 629:(9): 2043–8. 628: 624: 620: 613: 610: 605: 601: 597: 593: 589: 585: 581: 577: 573: 569: 562: 559: 547: 541: 538: 533: 529: 524: 519: 515: 511: 506: 501: 497: 493: 489: 485: 481: 474: 471: 460: 454: 451: 446: 442: 437: 432: 429:(9): 1085–6. 428: 424: 420: 413: 410: 406: 402: 396: 393: 387: 383: 380: 378: 375: 373: 370: 369: 365: 363: 359: 356: 354: 350: 345: 344: 337: 329: 327: 321: 320: 319: 317: 309: 308: 307: 304: 301: 298: 292: 290: 287: 285: 281: 277: 276:hyponatraemia 273: 269: 267: 263: 259: 255: 250: 248: 244: 240: 236: 232: 228: 220: 218: 216: 210: 208: 204: 195: 193: 191: 188:Normal human 183: 178: 176: 174: 170: 160: 157: 154: 151: 150: 146: 143: 140: 136: 132: 129: 125: 122: 121: 117: 114: 111: 108: 107: 104: 101: 98: 94: 86: 84: 82: 78: 70: 68: 66: 62: 58: 54: 50: 46: 42: 38: 36: 32: 22: 19: 1254:Elevated ALP 1220:Hypouricemia 1189:Hypoglycemia 1125:Unconjugated 1090: 822: 773:Electrolytes 721:. Retrieved 717:the original 707: 685:(6): 653–9. 682: 678: 626: 622: 612: 571: 567: 561: 550:. Retrieved 540: 487: 483: 473: 462:. 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RNCEUS 532:24591588 445:14524639 366:See also 196:Nonhuman 147:mOsm/kg 65:solution 53:kilogram 1150:Amylase 875:Lactate 870:content 796:Calcium 604:9284617 523:3970477 492:Bibcode 316:ethanol 161:mOsm/L 112:Source 109:Origin 97:divisor 63:(L) of 57:solvent 49:osmoles 1155:Lipase 781:Sodium 697:  661:898032 659:  651:  633:  623:Stroke 602:  594:  586:  530:  520:  512:  443:  245:them ( 243:lysing 179:Ranges 118:Units 1280:Other 657:S2CID 600:S2CID 266:urine 254:blood 184:Human 133:, or 61:liter 811:Urea 695:PMID 649:PMID 592:PMID 584:ISSN 528:PMID 510:ISSN 441:PMID 340:The 43:and 1241:LFT 1115:GGT 1103:AST 1098:ALT 1086:ALP 988:HDL 983:LDL 687:doi 641:doi 576:doi 572:162 518:PMC 500:doi 488:111 431:doi 403:," 225:As 55:of 1308:: 866:CO 693:. 683:38 681:. 669:^ 655:. 647:. 639:. 627:31 625:. 621:. 598:. 590:. 582:. 570:. 526:. 516:. 508:. 498:. 486:. 482:. 439:. 427:23 425:. 421:. 286:. 141:) 83:. 868:2 756:e 749:t 742:v 726:. 701:. 689:: 663:. 643:: 606:. 578:: 555:. 534:. 502:: 494:: 467:. 447:. 433:: 399:" 213:(

Index

electrolyte–water balance
Osmolality
osmolarity
osmoles
kilogram
solvent
liter
solution
osmometer
freezing point
osmolarity
divisor
freezing point depression
osmometer
vapor pressure
osmometer
osmolarity
osmolality
reference range
hypertonic
uricotelic
cell membranes
extracellular fluid
intracellular fluid
hypotonic
lysing
cytolysis
blood
dehydration
antidiuretic hormone

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