Test Catalog

Test Id : NH3V

Ammonia, Plasma

Useful For
Suggests clinical disorders or settings where the test may be helpful

Assisting in the diagnosis of hepatic coma

 

Investigating and monitoring treatment for inborn errors of metabolism

 

Evaluating patients with advanced liver disease

Method Name
A short description of the method used to perform the test

Photometric, Bromophenol Blue

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Ammonia, P

Aliases
Lists additional common names for a test, as an aid in searching

NH3 (Ammonia), Plasma

Specimen Type
Describes the specimen type validated for testing

Plasma EDTA

Shipping Instructions

Plasma must be separated from cells and frozen within 2 hours of collection. Freeze plasma on dry ice or in a freezer (-60 to -80 degrees C) for long-term storage or shipment.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube: Lavender top (EDTA)

Submission Container/Tube: Plain, plastic screw-top tube

Specimen Volume: 0.5 mL or more

Collection Instructions:

1. Specimens should be put on ice immediately after collection.

2. Centrifuge at refrigerated temperature (4 degrees C).

3. Aliquot plasma into plastic screw-top tube. Keep on ice.

4. Freeze plasma within 2 hours of collection.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

See Specimen Collection

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Plasma EDTA Frozen (preferred) 7 days
Refrigerated 2 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Assisting in the diagnosis of hepatic coma

 

Investigating and monitoring treatment for inborn errors of metabolism

 

Evaluating patients with advanced liver disease

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Ammonia is a waste product of protein catabolism; it is potentially toxic to the central nervous system. Increased plasma ammonia may be indicative of hepatic encephalopathy, hepatic coma in terminal stages of liver cirrhosis, hepatic failure, acute and subacute liver necrosis, and Reye's syndrome. Hyperammonemia may also be found with increasing dietary protein intake.

 

The major cause of hyperammonemia in infants includes inherited deficiencies of urea cycle enzymes, inherited metabolic disorders of organic acids and the dibasic amino acids lysine and ornithine, and severe liver disease.

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.

< or =30 mcmol/L

Interpretation
Provides information to assist in interpretation of the test results

Plasma ammonia concentrations do not correlate well with the degree of hepatic encephalopathy.

 

Elevated ammonia concentration may also be found with increased dietary protein intake.

 

Plasma ammonia concentrations in newborns younger than one week are elevated compared to adults. Values less than or equal to 82 mcmol/L have been observed.(1)

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Specimens should be put on ice immediately after collection, centrifuged at refrigerated temperature, and plasma kept on ice until analyzed.

 

Proper specimen handling is critical; false increases in ammonia may occur if transport and processing instructions are not strictly followed.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Madigan T, Block DR, Carey WA, et al: Proposed plasma ammonia reference intervals in a reference group of hospitalized term and preterm neonates. J App Lab Med. 2020 Mar 1;5(2):363-369

2. Rosenberg W: Liver disease. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:1348-1397

Method Description
Describes how the test is performed and provides a method-specific reference

Patient specimen is deposited on the slide where the spreading layer promotes the uniform distribution of the specimen. Water and nonproteinaceous components travel to the underlying buffered reagent layer. The ammonia in the sample then diffuses through the semipermeable membrane to react with the ammonia indicator in the second reagent layer. The semipermeable membrane allows only the ammonia to pass and prevents buffer or hydroxyl ions from reaching the indicator layer where they would react with the indicator. After a fixed incubation period, the reflection density of the dye is measured using the white background of the spreading layer as a diffuse reflector.(Package insert: VITROS Chemistry Products Ammonia Instructions for Use, Version 11.0 Ortho-Clinical Diagnostics, Inc; 2019)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 day

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

1 day

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82140

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
NH3V Ammonia, P 16362-6
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
NH3V Ammonia, P 16362-6

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports