Adverse Effects

Paraldehyde Intoxication

  • Diagnosis
    • ABG: AG usually >20
    • Normal Osmolal Gap (measured serum Osm – calculated serum Osm):
      • Normal gap: 15-20
      • Elevated osmolal gap indicates presence of a low MW solute (acetone/ETOH/ethylene glycol/isopropanol/MeOH) or unmeasured electrolyte (Mg) or sugar (mannitol/sorbitol/glycine)
      • Measured Serum Osm = from laboratory
      • Calculated Serum Osm = (2 x Na) + (glucose/18) + (BUN/2.8)
    • BUN: normal
    • Acetest/Ketostix (Nitroprusside reaction only detects acetoacetic acid):
      • When a nitroprusside reaction test is used, paraldehyde may cause a false-positive reaction for ketones, called “pseudoketosis”
      • Acetaldehyde can be found in the urine and blood, but many laboratories do not automatically test for this
  • Clinical
    • Paraldehyde Odor:


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