Increased Osmolal Gap in Alcoholic Ketoacidosis and Lactic Acidosis
| Autor: | Sara D. Winter, Stuart L. Linas, Randy L. Howard, Jeffrey R. Schelling |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Adult
Male Cross-sectional study Osmolar Concentration Alcoholic ketoacidosis Internal Medicine medicine Humans ALCOHOL INGESTION Aged Acidosis Analysis of Variance business.industry Ketosis General Medicine Middle Aged medicine.disease Cross-Sectional Studies Lactic acidosis Anesthesia Acidosis Lactic Female medicine.symptom business Alcoholic Intoxication |
| Zdroj: | Annals of Internal Medicine. 113:580 |
| ISSN: | 0003-4819 |
| Popis: | To determine whether an elevated osmolal gap is specific for toxic alcohol ingestion.Cross-sectional.Emergency room and medical and surgical inpatient wards at a university-affiliated hospital.Twenty-three patients with lactic acidosis, 19 with alcoholic ketoacidosis, and 10 randomly selected controls.Calculated and measured serum osmolality was determined in all study participants. The osmolal gap was increased in patients with lactic acidosis (17.4 +/- 5.4 mmol/kg) and alcoholic ketoacidosis (26.9 +/- 7.6 mmol/kg) when compared with controls (-1.7 +/- 1.7 mmol/kg, P less than 0.05 for both comparisons). When ethanol was included in the calculation, the osmolal gap remained elevated in the lactic acidosis (10.3 +/- 2.0 mmol/kg) and alcoholic ketoacidosis (11.1 +/- 3.2 mmol/kg) groups (P less than 0.05 for both comparisons).The osmolal gap is often used as a screen for toxic alcohol ingestion. When calculating the osmolal gap, the contribution of ethanol should be considered. An elevated osmolal gap is not specific for toxic alcohol ingestion, as the osmolal gap was elevated in patients with lactic acidosis and alcoholic ketoacidosis. These two conditions should be considered when using the osmolal gap to design therapy (for example, hemodialysis) in the setting of anion gap metabolic acidosis and suspected toxic alcohol ingestion. |
| Databáze: | OpenAIRE |
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