Ethanol Ingestion — Commonest Cause of Elevated Plasma Osmolality?

THE determination of plasma osmolality has found increasing clinical use over the past 10 years and is now a readily available procedure in many routine clinical laboratories. Although under ordinary circumstances plasma osmolality is primarily determined by the concentration of inorganic ions, other substances contribute to it and, in certain pathologic states, may cause appreciable elevation of the plasma osmolality over that contributed by inorganic ions alone. Thus, diabetes mellitus and uremia have long been recognized to be associated with substantial discrepancies between the plasma osmolality as determined by colligative measurements and that "predicted" on the basis of plasma sodium . . .