Ibrahim A Hashim1, Jennifer A Cuthbert2. 1. Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Parkland Memorial Hospital, Parkland Health and Hospital System, Dallas, TX 75235, USA. Electronic address: Ibrahim.Hashim@utsouthwestern.edu. 2. Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Parkland Memorial Hospital, Parkland Health and Hospital System, Dallas, TX 75235, USA.
Abstract
BACKGROUND: No study has explored the separate contributions of pre-analytical and analytical factors to hyperammonemia. METHODS: Laboratory information systems were queried for tests of ammonia concentrations over a 12 month period. Pre-analytic (collection to laboratory receipt) and analytic (laboratory receipt to result) elapsed times were determined. RESULTS: Under routine conditions for 3626 tests, normal and elevated results were similarly distributed if the time from venipuncture to result was <120 min. Delays, during analysis performance and in transportation to the laboratory, potentially contributed to hyperammonemia in a small number of samples (n=96, 2.7%). Similar results were obtained from a second hospital with a separate laboratory. CONCLUSIONS: Delays, in either transportation to the laboratory after collection or before completion of analysis, have the potential to elevate ammonia concentrations and may cause pseudo-hyperammonemia. Unexpectedly elevated ammonia concentrations need to be evaluated for errors in sampling handling.
BACKGROUND: No study has explored the separate contributions of pre-analytical and analytical factors to hyperammonemia. METHODS: Laboratory information systems were queried for tests of ammonia concentrations over a 12 month period. Pre-analytic (collection to laboratory receipt) and analytic (laboratory receipt to result) elapsed times were determined. RESULTS: Under routine conditions for 3626 tests, normal and elevated results were similarly distributed if the time from venipuncture to result was <120 min. Delays, during analysis performance and in transportation to the laboratory, potentially contributed to hyperammonemia in a small number of samples (n=96, 2.7%). Similar results were obtained from a second hospital with a separate laboratory. CONCLUSIONS: Delays, in either transportation to the laboratory after collection or before completion of analysis, have the potential to elevate ammonia concentrations and may cause pseudo-hyperammonemia. Unexpectedly elevated ammonia concentrations need to be evaluated for errors in sampling handling.
Authors: Virginia Gutiérrez-de-Juan; Sergio López de Davalillo; David Fernández-Ramos; Lucía Barbier-Torres; Imanol Zubiete-Franco; Pablo Fernández-Tussy; Jorge Simon; Fernando Lopitz-Otsoa; Javier de Las Heras; Paula Iruzubieta; María Teresa Arias-Loste; Erica Villa; Javier Crespo; Raúl Andrade; M Isabel Lucena; Marta Varela-Rey; Shelly C Lu; José M Mato; Teresa Cardoso Delgado; María-Luz Martínez-Chantar Journal: PLoS One Date: 2017-03-20 Impact factor: 3.240
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