Referred Tests
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Test ID: VLTB
Volatile Screen, Blood
Useful For 
Suggests clinical disorders or settings where the test may be helpful
Detection and quantitation of acetone, methanol, isopropanol, and ethanol in whole blood
Quantification of the concentration of ethanol in blood that correlates with the degree of intoxication
Evaluation of toxicity to the measured volatile substances
This test is not intended for use in employment-related testing.
Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Volatile substances in the blood include ethanol, methanol, isopropanol, and acetone. Acetone is generally elevated in metabolic conditions such as diabetic ketoacidosis. Methanol and isopropanol are highly toxic and result from exogenous ingestion.
Ethanol is the single most important substance of abuse in the United States. It is the active agent in beer, wine, vodka, whiskey, rum, and other liquors. Ethanol acts on cerebral function as a depressant similar to general anesthetics. This depression causes most of the typical symptoms such as impaired thought, clouded judgment, and changed behavior. As the level of alcohol increases, the degree of impairment progressively increases.
In most jurisdictions in the United States, the per se blood level for being under the influence of alcohol (ethanol) for purposes of driving a motor vehicle is 80 mg/dL.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
METHANOL
Not detected (Positive results are quantitated.)
Toxic concentration: > or =10 mg/dL
ETHANOL
Not detected (Positive results are quantitated.)
Toxic concentration: > or =400 mg/dL
ISOPROPANOL
Not detected (Positive results are quantitated.)
Toxic concentration: > or =10 mg/dL
ACETONE
Not detected (Positive results are quantitated.)
Toxic concentration: > or =10 mg/dL
Interpretation Provides information to assist in interpretation of the test results
Methanol:
The presence of methanol indicates exposure which may result in intoxication, central nervous system (CNS) depression, and metabolic acidosis. Ingestion of methanol can be fatal if patients do not receive immediate medical treatment.
Ethanol:
The presence of ethanol indicates exposure which may result in intoxication, CNS depression, and metabolic acidosis.
Isopropanol:
The presence of isopropanol indicates exposure which may result in intoxication and CNS depression. Ingestion of isopropanol can be fatal if patients do not receive immediate medical treatment.
Acetone:
The presence of acetone may indicate exposure to acetone; it is also a metabolite of isopropanol and may be detected during ketoacidosis.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
This test does not detect ethylene glycol.
Clinical Reference Recommendations for in-depth reading of a clinical nature
1. Langman LJ, Bechtel LK, Meier BM, Holstege C: Chapter 41: Clinical Toxicology. In: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Edited by N Rifai, AR Horvath, CT Wittwer. Sixth edition. Elsevier; 2018. pp. 832-87
2. Mihic SJ, Koob GF, Mayfield J, Harris RA: Ethanol. In: Goodman & Gilman's: The Pharmacological Basis of Therapeutics, 13th edition. Edited by LL Brunton, R Hilal-Dandan, BC Knollmann. McGraw-Hill Education; 2017
3. Olson KR, Anderson IB, Benowitz NL, et al: Specific Poisons and Drugs: Diagnosis and Treatment. In Poisoning and Drug Overdose, Seventh edition. McGraw-Hill Education; 2017