Abstract
Colloid osmotic pressure (COP) is determined by the osmotic pressure exerted by colloids and their associated cations across a semipermeable membrane. Direct measurement via a colloid osmometer is the only way to accurately monitor COP in critically ill patients as calculation from equations is inaccurate in nonhealthy patients. Plasma osmolality can be estimated using an equation or measured directly via a freezing point depression osmometer. Freezing point depression is considered the gold standard. Comparison of measured osmolality and calculated osmolality allows for the diagnosis of an osmolal gap. A gap of more than 10 mOsm/kg indicates the presence of an unmeasured osmole(s), such as ethanol or ethylene glycol and its metabolites, and may be clinically useful in diagnosing these toxicities.
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