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Review of literature has suggested that the osmolal gap can be increased in patients with ethanol-induced acidosis without the presence of other alcohols, [10] presumably owing to the presence of acetone, which is produced by ethanol metabolism and by starvation .
2) In addition to screening tests for toxins, calculation of the osmolal gap (OG) as osmolality - (2[Na+] + [urea] + [glucose]), may be helpful as an indicator of intoxication.
Anion and osmolal gaps in the diagnosis of methanol poisoning: clinical study in 28 patients.
3 (B) Serum bicarbonate < 20 meq/L (C) Osmolal gap > 10 mOsm/L (D) Urinary oxalate crystals present (in the case of EG poisoning) Data are from the American Academy of Clinical Toxicology Ad Hoc Committee on the Treatment Guidelines for Ethylene Glycol and Methanol Poisoning.
3 mmol/L; anion gap, 14 mmol/L; and osmolal gap, 72 mOsm/kg.
The increased osmolal gap observed in this case could not be explained by ethanol alone.
The osmolal gap (OG) [1] is calculated in the emergency department (ED) when ingestion of ethylene glycol, methanol, isopropyl alcohol, acetone, or other osmotically active substances are suspected.
6 Acetaminophen, [micro]mol/L 1218 <66 78 EtOH, mmol/L Advia 1650 33 33 34 RXL MAX <2 <2 <2 Gas chromatograph <2 <2 <2 Measured osmolality, mmol/kg 306 286 278 Osmolal gap Calculated using EtOH from Advia 1650 -23 -42 -44 Calculated using EtOH from gas chromatograph 18 -1 -1 (a) Acetaminophen concentrations were measured at approximately 24, 96, and 48 h after ingestion for patients 1, 2, and 3, respectively.
Background: The osmolal gap (OG) is a screening test for the detection of toxic volatiles such as methanol and ethylene glycol.