Difference between osmolarity, osmolality and tonicity - Deranged Physiology http://www.derangedphysiology.com/main/core-topics-intensive-care/ma...

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Deranged Physiology Home Core Topics in Intensive Care Manipulation of Fluids and Electrolytes Chapter 0.1.2

Di#erence Between Osmolarity, Osmolality and Tonicity

Osmolarity
Osmolarity is the measure of solute concentration per unit VOLUME of solvent.
Its not the same as tonicity! Osmolarity takes into account ALL of the solute concentrations, not just the ones that cant cross the semipermeable
membrane.

Osmolality
Osmolality is the measure of solute concentration per unit MASS of solvent.
You never measure osmolarity in practice, because water changes its volume according to temperature (but mass remains the same, and so it is
more convenient and consistent)
Osmolality is the same in the ICF and the ECF.
Both inside and outside, the osmolality is 285-290 mOsm/Kg.
Stubbornly, in spite of the membrane being water-impermeable lipid, water moves across the cell membrane well enough; more on this later.

Tonicity
Tonicity is the measure of the osmotic pressure gradient between two solutions.
Unlike osmolarity, tonicity is only in uenced by solutes that cannot cross this semipermeable membrane, because these are the only solutes
in6uencing the osmotic pressure gradient.
7us, you can have iso-osmolar solutions which are not isotonic.

Iso-osmolar solutions which are not isotonic: 5% dextrose and intracellular uid

5% dextrose, when infused, is iso-osmolar with the body 6uid compartments. Its osmolality is the same as the osmolality of the cellular contents
(about 300mOsm/L) However, because dextrose penetrates the cells so easily, it cannot contribute to tonicity. 7us, the infused dextrose is
iso-osmolar but hypotonic.
7us, a solution can be iso-osmolar and hypotonic, when the solute contributing to its osmolality is not a solute which can contribute to its
tonicity. 7ese osmoles, which don't contribute to the tonicity, are derisively termed "ine>ective osmoles" by Brandis. Dextrose and urea are the
main ine>ective osmoles. In a diabetic patient, dextrose can still be an e>ective osmole.

Dextrose and urea are the main ine ective osmoles.

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Difference between osmolarity, osmolality and tonicity - Deranged Physiology http://www.derangedphysiology.com/main/core-topics-intensive-care/ma...

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In a diabetic patient, dextrose can still be an e>ective osmole.

7e major "e>ective" osmole is SODIUM.
Sodium and its anion harem contribute to 86% of the osmolality and 92% of the tonicity.

References
References
anaesthesiamcq.org, as always;
My source for some of this information has been Ohs Manual (6th edition), speciDcally chapter 84 by Simon Finfer and Anthony
Delaney.
Most of this information derives from easily accessible physiology textbooks, such as Ganongs Review of Medical Physiology 23rd
edition.

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