Lactate and the osmolar gap
نویسنده
چکیده
Although the teaching case report in the March 27 issue on a negative anion gap and elevated osmolar gap resulting from lithium overdose is interesting, I identified the following concern. In the third paragraph from the end of the report, the authors listed lactate as one of the potential causes of an elevated osmolar gap that they excluded. It is unfortunate that they perpetuated this common misperception of the role of lactate. An elevated lactate concentration does not account for an elevated osmolar gap because the lactate is accounted for in the osmolality calculation by multiplying the sodium concentration by 2.
منابع مشابه
Colloquium on rethinking the future of scientific communication.
1. Oxalate crystals may occur in the CSF with ethylene glycol poisoning or primary hyperoxaluria type 1. Ethylene glycol is metabolized by alcohol dehydrogenase to form glycolic and oxalic acids. 2. Serum electrolytes and osmolality can be measured, and the anion and osmolar gaps can be calculated. Ethylene glycol poisoning is associated with an increased osmolar gap and increased anion gap met...
متن کاملAcid-Base Made Easy
The differential diagnoses for acid-base problems can be reduced to a workable few by using a minimal amount of laboratory data. Following well-established principles and formulas, the presenter will help you resolve common acidbase problem cases. • Identify etiologies of anion gap and non-anion gap acidosis. • Explain the principle of osmolar gap. • Differentiate the causes of acid-base distur...
متن کاملAcute Kidney Injury, Myocardial Infarction and Death Following Brake Fluid Poisoning; A Case Report
Background: Ethylene glycol is a toxic alcohol which is used in brake fluid, antifreeze, coolants, preservatives and chemical solvents. Ethylene glycol poisoning usually results in depression of the central nervous system, renal insufficiency and cardiopulmonary compromise, while laboratory findings include metabolic acidosis, increased anion gap, increased osmolar gap and calcium oxalate cryst...
متن کاملOsmolar relation between cerebrospinal fluid and serum in hyperosmolar hypernatraemic dehydration.
The relation between cerebrospinal fluid (CSF) and serum osmolality was studied in 16 patients with hyperosmolar hypernatraemic dehydration before treatment. After correcting shock and acidosis, 0-45% saline in 2-5 or 5% dextrose was infused in each patient over a 48- to 72-hour period. During rehydration, serum osmolality, electrolyte concentrations, urea nitrogen, and blood pH were measured s...
متن کاملTargeted metabolomics in colorectal cancer: a strategic approach using standardized laboratory tests of the blood and urine
BACKGROUND Glycolytic markers have been detected in colorectal cancer (CRC) using advanced analytical methods. METHODS Using commercially available assays, by-products of anaerobic metabolism were prospectively measured in the blood and urine of 20 patients with metastatic colorectal cancer (mCRC) and 20 patients with local disease. Twenty-four-hour urine citrate, plasma lactate, ketones, ven...
متن کامل