Evaluating acutely ill or comatose patients
Freezing Point Depression
Osmolality, Serum
Serum
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 2 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.
0.25 mL
Gross hemolysis | OK |
Gross lipemia | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 7 days | |
Frozen | 7 days | ||
Ambient | 24 hours |
Evaluating acutely ill or comatose patients
Osmolality is a measure of the number of dissolved solute particles in solution. It is determined by the number and not by the nature of the particles in solution.
Dissolved solutes change the physical properties of solutions, increasing the osmotic pressure and boiling point and decreasing the vapor pressure and freezing point.
Serum osmolality increases with dehydration and decreases with overhydration. The patient receiving intravenous fluids should have a normal osmolality. If the osmolality rises, the fluids contain relatively more electrolytes than water. If the osmolality falls, relatively more water than electrolytes is being administered.
Normally, the ratio of serum sodium, in mEq/L, to serum osmolality, in mOsm/kg, is between 0.43 and 0.5. The ratio may be distorted in drug intoxication.
Generally, the same conditions that decrease or increase the serum sodium concentration affect the osmolality.
A comparison of measured and calculated serum osmolality produces a delta-osmolality. If this is above 40 mOsm/kg H2O in a critically ill patient, the prognosis is poor.
An easy formula to calculate osmolality is:
Osmolality (mOsm/kg H2O)=2 Na+ | Glucose | + | BUN |
20 | 3 |
275-295 mOsm/kg
An increased gap between measured and calculated osmolality may
No significant cautionary statements
1. Murphy JE, Henry JB: Evaluation of renal function, and water, and electrolyte, and acid base balance. In: Henry JB, ed: Todd-Sanford-Davidsohn Clinical Diagnosis and Management by Laboratory Methods. 19th ed. WB Saunders Company; 2006
2. Delaney MP, Lamb EJ: Kidney disease. In: Rifai N, Horvath AR, Wittwer CT, eds: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:1306
The depression of the freezing point of serum or other fluid is used to measure osmolality in most osmometers. The extent of lowering below 0 degrees C (the freezing point of water) is a function of the concentration of substances dissolved in the serum. By definition, 1 milliosmole per kilogram lowers the freezing point 0.001858 degrees C.(Schindler EI, Brown SM, Scott MG: Electrolytes and blood gases. In: Rifai N, Horvath AR, Wittwer CT, eds: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:610-612)
Monday through Sunday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
83930
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
UOSMS | Osmolality, S | 2692-2 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
UOSMS | Osmolality, S | 2692-2 |