Abstract:
:Background Measured (MO) and calculated osmotic concentrations (CO) and the osmotic gap (OG) are commonly used in the investigation of electrolyte and volume disturbances as well as in cases of suspected volatile ingestion. Methods We compared 38 published formulae for CO with MO on a large data-set ( n = 9466) and adjusted the CO with the result of a Passing-Bablok regression procedure. Validation of this adjustment was performed with a separate data-set ( n = 2082). Results All but one of the CO formulae underestimate MO due to a proportional bias (slope 0.67 to 0.95) and the OG limits were therefore not applicable throughout the observed range. Using Passing-Bablok regression to adjust the CO: CO#3 = (2 × Na+urea+glucose-14.54)/0.93. After adjustment, the mean OG was 0.3 mmol/L with a SD of 5.1 mmol/L across the measurement interval. The distribution of the OG could be fully explained by the analytical imprecision of the measured components. Conclusions Simple adjustment of the CO for the proportional underestimation of MO allows OG reference limits of approximately -10 to +10 mmol/L to be used, even in the upper ranges of CO in patients with suspected volatile ingestion.
journal_name
Ann Clin Biochemjournal_title
Annals of clinical biochemistryauthors
Wilgen U,Pretorius CJ,Ungerer JPdoi
10.1177/0004563217694052subject
Has Abstractpub_date
2018-01-01 00:00:00pages
136-142issue
1eissn
0004-5632issn
1758-1001journal_volume
55pub_type
杂志文章abstract:BACKGROUND:The rapid exclusion of acute myocardial infarction in patients with chest pain can reduce the length of hospital admission, prevent unnecessary diagnostic work-up and reduce the burden on our health-care systems. The combined use of biomarkers that are associated with different pathophysiological aspects of ...
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