Test Id : VLTS
Volatile Screen, Serum
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Detection and quantitation of acetone, methanol, isopropanol, and 
Quantification of the concentration of ethanol in serum
Evaluation of toxicity to the measured volatile substances
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    This test includes analysis for methanol, ethanol, isopropanol, and acetone.
    
        Method Name
            
                
                
                    
                    A short description of the method used to perform the test
                
            
    
    Headspace Gas Chromatography Flame Ionization Detector (HSGC-FID)
    
        NY State Available
            
                
                
                    
                    Indicates the status of NY State approval and if the test is orderable for NY State clients.
                
            
    
    
    
        Reporting Name
            
                
                
                    
                    Lists a shorter or abbreviated version of the Published Name for a test
                
            
    
    
    
        Aliases
            
                
                
                    
                    Lists additional common names for a test, as an aid in searching
                
            
    
    Acetone
Alcohol
Ethanol
Ethyl Alcohol
ETOH (Ethanol)
Isopropanol
Methanol
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    This test includes analysis for methanol, ethanol, isopropanol, and acetone.
    
        Specimen Type
            
                
                
                    
                    Describes the specimen type validated for testing
                
            
    
        Serum
    
        Additional Testing Requirements
    
    If measurement of ethylene glycol is also needed, order ETGL / Ethylene Glycol, Serum in addition to this test.
    
        Specimen Required
            
                
                
                    
                    Defines the optimal specimen required to perform the test and the preferred volume to complete testing
                
            
    
    Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial for serum collected in red-top tubes only.
Specimen Volume: Full tube
Collection Instructions:
1. Do not use alcohol to clean arm. Use alternative such as Betadine to cleanse arm before collecting any specimen for volatile testing.
2. Avoid exposure of specimen to atmosphere.
3. Centrifuge serum gel tubes with 2 hours of collection but do not aliquot.
4. Centrifuge red-top tubes and aliquot serum in plastic vial within 2 hours of collection.
    
        Special Instructions
            
                
                
                    
                    Library of PDFs including pertinent information and forms related to the test
                
            
    
    
            
    
        Forms
    
    If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
    
        Specimen Minimum Volume
            
                
                
                    
                    Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
                
            
    
    0.5 mL
    
        Reject Due To
            
                
                
                    
                    Identifies specimen types and conditions that may cause the specimen to be rejected
                
            
    
    | Gross hemolysis | OK | 
| Gross lipemia | OK | 
| Gross icterus | OK | 
    
        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 | 
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Ambient | 24 hours | ||
| Frozen | 28 days | 
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Detection and quantitation of acetone, methanol, isopropanol, and 
Quantification of the concentration of ethanol in serum
Evaluation of toxicity to the measured volatile substances
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    This test includes analysis for methanol, ethanol, isopropanol, and acetone.
    
        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. Methanol and isopropanol are highly toxic; toxicity results from ingestion (exogenous). Acetone is generally elevated in metabolic conditions such as diabetic ketoacidosis (endogenous). It also is a metabolite of isopropanol.
Ethanol is one of the most widely abused legal substances 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.
On average, the serum or plasma concentration of the alcohols is 1.2-fold higher than blood concentration. For example, the serum or plasma would contain approximately 0.10 g/dL of ethanol in a blood specimen that contains 0.08 g/dL ethanol. Due to potential variations in the serum to whole blood ratio, serum should not be used in a medico-legal context. However, in the context of medical/clinical assessment, serum or plasma may be submitted for analysis.
    
        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 that 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 that may result in intoxication, CNS depression, and metabolic acidosis.
Isopropanol:
The presence of isopropanol indicates exposure that 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
                
            
    
    No significant cautionary statements
    
        Clinical Reference
            
                
                
                    
                    Recommendations for in-depth reading of a clinical nature
                
            
    
    1. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43
2. Mayfield J, Mihic SJ. Ethanol. In: Brunton LL, Knollmann BC. Goodman and Gilman's: The Pharmacological Basis of Therapeutics. 13th ed. McGraw-Hill Education; 2022:chap 27
3. Olson KR, Anderson IB, Benowitz NL, et al. Specific Poisons and Drugs: Diagnosis and Treatment. In: Poisoning and Drug Overdose. 8th ed. McGraw-Hill; 2022:section II
    
        Method Description
            
                
                
                    
                    Describes how the test is performed and provides a method-specific reference
                
            
    
    Samples are analyzed and quantified by headspace gas chromatography with flame ionization detection.(Baselt RC. Disposition of Toxic Drugs and Chemicals in Man. 10th ed. Biomedical Publications; 2014:2211)
    
        PDF Report
            
                
                
                    
                    Indicates whether the report includes an additional document with charts, images or other enriched information
                
            
    
    
    
        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 Saturday
    
        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.
                
            
    
    
    
        Specimen Retention Time
            
                
                
                    
                    Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
                
            
    
    
    
        Performing Laboratory Location
            
                
                
                    
                    Indicates the location of the laboratory that performs the test
                
            
    
    
    
        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 account representative. 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 was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
    
        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.
                
            
    
    
            
            
            CPT codes are provided by the performing laboratory.
    
        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 | 
|---|---|---|
| VLTS | Volatile Scrn, S | 50025-6 | 
| 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.
                                     | 
|---|---|---|
| 8632 | Volatile Scrn, S | 32044-0 | 
| 30917 | Methanol, S | 5693-7 | 
| 30918 | Ethanol, S | 5643-2 | 
| 30919 | Acetone, S | 5568-1 | 
| 30920 | Isopropanol, S | 5669-7 | 
| 34376 | Chain of Custody | 77202-0 |