Infusion Nurse Blog

Is there a difference? Osmolarity vs. Osmolality..

infusionnurse

8 years ago

These terms have always been confusing and perhaps like many other nurses, sometimes, I
can’t figure out which one to use. In infusion therapy, particularly with Fluids and
Electrolytes and IV solutions, these two terms certainly have important roles and
understanding each term will be helpful to us.

 Osmolarity and Osmolality are both units of measurements. What these two terms measure
and calculate is the osmotic activity. Remember, osmotic activity is when one solution , usually
lower in conductivity or mineral content, passes through a semi-permeable barrier for the
purpose of diluting the concentration of the solution on the other side, usually containing a
higher conductivity or mineral content.
 The measurements are expressed as:
o Osmoles and milliosmoles – to describe the solute particles contained in a solution

 Osmolarity is the number of milliosmoles/liter (mOsm/L) of solution. It is the concentration of

an osmotic solution. This is the common bedside calculation used in clinical settings for osmotic
activity.
o Example: Plasma and other body fluid osmolarity: 270 – 300 mOsm/L

 Osmolality is the number of milliosmoles/ kg (mOsm/kg ) of solvent. It is the concentration of

the particles that is dissolved in a fluid. This is the clinical laboratory measurement using an
osmometer.
o Example: Urine osmolality: extreme range of 50 – 1400 mOsm/kg water, but average is about
500 – 800 mOsm. After an overnight fast, the urine osmolality should be at least 3 times the
serum osmolality.
o Example: Serum osmolality: 282 – 295 mOsm/kg water

The difference between the calculated osmolarity and measured osmolality is called
the “osmolar gap” and is often used as part of differential diagnostic evaluation of patients.
If the concentration of solutes in the given fluid is very low, then osmolarity and osmolality
are considered to be equivalent.

When all body fluids have an osmolarity near 300 mOsm/L, the osmotic pressure of the two
fluid compartments are equal = no net water movement occurs. This is called iso-osmotic
or isotonic.

 IV fluid solutions 270-300 mOsm/L = Isotonic (eg 0.9% Sodium Chloride)

 IV fluid solutions >300 mOsm/L = Hypertonic (eg D2.5% in Water)
 IV fluid solutions <270 mOsm/L = Hypotonic (eg D5% 0.9%Sodium Chloride)
 Hypotonic solutions will move water into the cell, causing the cell to swell and potential
burst. By lowering the serum osmolarity, the body fluids shift out of the blood vessels into
the interstitial tissue and cells. Hypotonic solutions hydrate the cells and can deplete the
circulatory system.

Hypertonic solutions conversely cause the water from within a cell to move to the ECF
compartment, causing the cell to shrink. These solutions are used to replace electrolytes.
Hypertonic dextrose solutions when used alone, shifts ECF from interstitial to plasma.

As infusion nurses, we know anything with an osmolarity of greater than 600, is not
recommended for peripheral IV infusion.

So now you know….is it osmolarity or osmolality???

Reference:
Erstad BL. Osmolarity and Osmolality: narrowing the terminology gap. Pharmacotherapy
2003;23(9):1085-1086

Categories: Fluid & Electrolytes, Infusion Nursing, Nursing

Tags: Fluids & Electrolytes, Infusion Nursing, Nursing

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