Serum osmolality and hyperosmolar states.
Serum osmolality is the sum of the osmolalities of every single dissolved particle in the blood such as sodium and associated anions, potassium, glucose, and urea. Under normal conditions, serum sodium concentration is the major determinant of serum osmolality. Effective blood osmolality, so-called...
| Publicado en: | Pediatric Nephrology Vol. 38; no. 4; pp. 1013 - 1026 |
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| Autores principales: | , |
| Formato: | review tables/charts Journal Article |
| Publicado: |
Springer Nature
Apr2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=161854837&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 161854837 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Apr2023 vid: 38 iid: 4 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 161854837 157743631 161854837 161854837 10.1007/s00467-022-05668-1 161854837 ppf: 1013 ppct: 13 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Serum osmolality and hyperosmolar states. aug: au: Büyükkaragöz, Bahar Bakkaloğlu, Sevcan A. affil: Department of Pediatric Nephrology, Gazi University, 06560, Besevler, Ankara, Turkey sug: subj: Serum Osmolar Concentration Hypernatremia Diabetic Ketoacidosis Mannitol ab: Serum osmolality is the sum of the osmolalities of every single dissolved particle in the blood such as sodium and associated anions, potassium, glucose, and urea. Under normal conditions, serum sodium concentration is the major determinant of serum osmolality. Effective blood osmolality, so-called blood tonicity, is created by the endogenous (e.g., sodium and glucose) and exogenous (e.g., mannitol) solutes that are capable of creating an osmotic gradient across the membranes. In case of change in effective blood osmolality, water shifts from the compartment with low osmolality into the compartment with high osmolarity in order to restore serum osmolality. The difference between measured osmolality and calculated osmolarity forms the osmolal gap. An increase in serum osmolal gap can stem from the presence of solutes that are not included in the osmolarity calculation, such as hypertonic treatments or toxic alcoholic ingestions. In clinical practice, determination of serum osmolality and osmolal gap is important in the diagnosis of disorders related to sodium, glucose and water balance, kidney diseases, and small molecule poisonings. As blood hypertonicity exerts its main effects on the brain cells, neurologic symptoms varying from mild neurologic signs and symptoms to life-threatening outcomes such as convulsions or even death may occur. Therefore, hypertonic states should be promptly diagnosed and cautiously managed. In this review, the causes and treatment strategies of hyperosmolar conditions including hypernatremia, diabetic ketoacidosis, hyperglycemic hyperosmolar syndrome, hypertonic treatments, or intoxications are discussed in detail to increase awareness of this important topic with significant clinical consequences. pubtype: Academic Journal doctype: review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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