Anion and osmolal gaps in the diagnosis of methanol poisoning: clinical study in 28 patients

To evaluate anion and osmolal gaps as diagnostic tools in methanol poisoning. Clinical observational study. In a recent methanol outbreak, the initial triage and treatment decisions in 28 patients were based mainly upon the values of the osmolal and anion gaps on admission. Methanol and formate leve...

Full description

Saved in:
Bibliographic Details
Published in:Intensive care medicine 2004-09, Vol.30 (9), p.1842-1846
Main Authors: HOVDA, Knut Erik, HUNDERI, Odd Helge, RUDBERG, Nina, FROYSHOV, Sten, JACOBSEN, Dag
Format: Article
Language:English
Subjects:
Acid-Base Equilibrium
Acidosis
Acidosis - diagnosis
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Chromatography, Gas
Ethanol
Formates - blood
Humans
Intensive care medicine
Linear Models
Medical sciences
Metabolism
Metabolites
Methanol - blood
Methanol - poisoning
Observation
Poisoning
Poisoning - blood
Poisoning - diagnosis
Regression analysis
Solvents - analysis
Solvents - poisoning
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To evaluate anion and osmolal gaps as diagnostic tools in methanol poisoning. Clinical observational study. In a recent methanol outbreak, the initial triage and treatment decisions in 28 patients were based mainly upon the values of the osmolal and anion gaps on admission. Methanol and formate levels were later compared to these gaps by linear regression analysis. The correlation between the osmolal gaps and serum methanol concentrations on admission was linear (y = 1.03x+12.71, R2 = 0.94). The anion gaps correlated well with the serum formate concentrations (y = 1.12x+13.82, R2 = 0.86). Both gaps were elevated in 24 of the 28 subjects upon admission. Three patients had an osmolal gap within the reference area (because of low serum methanol), but elevated anion gap because of formate accumulation. One patient with probable concomitant ethanol ingestion had a high osmolal gap and a normal anion gap. Osmolal and anion gaps are useful in the diagnosis and triage of methanol-exposed subjects. Confounders are low serum methanol and concomitant ethanol ingestion.
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-004-2373-7