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
References