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Calculate
the predicted serum osmolality given the serum sodium,
glucose and blood urea nitrogen.
The
normal range of serum osmolality is 285-295 mOsm/L. The measured
osmolality should not exceed the predicted by more
than 10 mOsm/L. A difference of more than 10 mOsm/L is considered
an osmolal gap. Causes for a serum osmolal gap include
mannitol, ethanol, methanol, ethylene glycol and other toxins
in very high concentration, usually small molecules. The propylene
glycol in lorazepam may cause hyperosmolarity and sometimes
hyperosmolar coma in some patients, particularly when the
lorazepam is used as a continuous infusion.
The
equation is:
| Osmolality = 2 * Na +
|
Glu
|
+ |
BUN
|
|
|
|
|
18
|
2.8
|
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