Serum Osmolality Calculator

Calculate serum osmolality and osmotic gap for electrolyte and fluid balance assessment

Calculate Serum Osmolality

Normal range: 136-145 mEq/L (equivalent to mmol/L)

Normal range: 7-20 mg/dL (2.5-7.1 mmol/L)

Normal range: 70-99 mg/dL (3.9-5.5 mmol/L) fasting

Include when alcohol intoxication or poisoning is suspected

mOsm/kg H₂O

For osmotic gap calculation (normal range: 280-295 mOsm/kg H₂O)

Example Calculation

Diabetic Patient Example

Sodium (Na): 142 mEq/L

BUN: 28 mg/dL

Glucose: 450 mg/dL (diabetic ketoacidosis)

Alcohol: 0 mg/dL

Calculation

Osmolality = 2×142 + 28/2.8 + 450/18 + 0/3.7

Osmolality = 284 + 10 + 25 + 0

Osmolality = 319 mOsm/kg H₂O (High)

Normal Laboratory Values

Serum Osmolality

280-295 mOsm/kg H₂O

Sodium

136-145 mEq/L

BUN

7-20 mg/dL

Glucose (fasting)

70-99 mg/dL

Osmotic Gap

-14 to +10 mOsm/kg H₂O

Clinical Conditions

High Osmolality

  • • Dehydration
  • • Diabetes insipidus
  • • Hyperglycemia
  • • Hypernatremia
  • • Alcohol intoxication
  • • Kidney insufficiency

Low Osmolality

  • • Fluid overload
  • • SIADH
  • • Hyponatremia
  • • Paraneoplastic syndrome

High Osmotic Gap

  • • Methanol poisoning
  • • Ethylene glycol poisoning
  • • Salicylate toxicity
  • • Mannitol therapy

Understanding Serum Osmolality

What is Serum Osmolality?

Serum osmolality is a measure of the concentration of dissolved particles (osmotically active substances) in blood serum. It reflects the body's water-electrolyte balance and is crucial for maintaining proper cell function and fluid distribution.

Clinical Significance

  • Evaluates fluid and electrolyte disorders
  • Diagnoses poisoning or overdose
  • Monitors diabetes complications
  • Assesses kidney function

Formula Explanation

Osmolality = 2×Na + BUN/2.8 + Glucose/18 + Alcohol/3.7

  • 2×Na: Sodium and its associated anions (mEq/L)
  • BUN/2.8: Blood urea nitrogen contribution (mg/dL)
  • Glucose/18: Glucose contribution (mg/dL)
  • Alcohol/3.7: Ethanol contribution when present (mg/dL)

Osmotic Gap

The osmotic gap is the difference between measured and calculated osmolality. An elevated gap suggests unmeasured osmotically active substances.