GP1 2 PUH SHY Reference Ranges

Transcription

1 GP1 2 PUH SHY s Copy of version 4.0 (approved and current) Last Approval or Periodic Review Completed 5/17/2017 Next Periodic Review Needed On or Before 5/17/2018 Controlled Copy ID Location office Organization PUH CP Effective Date 5/17/2017 Description Year removed from title Comments for version 4.0 pco2, po2 and bicarbonate range changesupdated pco2, po2 and bicarbonate reference ranges. Approval and Periodic Review Signatures Type Description Date Version Performed By Notes Approval Lab Director 5/17/ Alan Wells Approval pathologist 5/16/ Lydia Contis Approval section supervisor 5/5/ Octavia Palmer Approval Manager 5/1/ Darla Lower Approval supervisor 4/28/ Katie Mulvey Approval Lab Director 1/31/ Alan Wells Approval pathologist 1/30/ Lydia Contis Approval section supervisor 1/30/ Octavia Palmer Approval Manager 1/25/ Darla Lower Approval supervisor 1/25/ Katie Mulvey Periodic review Pathologist 1/20/ Octavia Palmer Periodic review Periodic review supervisor 11/14/ Courtney Weir supervisor review 11/14/ Katie Mulvey Approval Lab Director 1/20/ Alan Wells Approval pathologist 1/20/ Lydia Contis Approval section supervisor 1/20/ Octavia Palmer Approval supervisor 1/20/ Justin Murphy Approval supervisor 1/20/ Katie Mulvey Approval supervisor 8/21/ Justin Murphy

2 Approval supervisor 8/21/ Katie Mulvey Approval Lab Director 3/9/ Alan Wells Recorded when document uploaded to MediaLab Periodic review Designated Reviewer 3/9/ Alan Wells Recorded when document uploaded to MediaLab Approvals and periodic reviews that occured before this document was added to the MediaLab Document Control system may not be listed. Version History Version Status Type Date Added Date Effective Date Retired 4.0 Approved and Current Major revision 4/18/2017 5/17/2017 Indefinite 3.2 Retired Minor revision 3/21/2017 4/3/2017 5/17/ Retired Minor revision 2/1/2017 2/3/2017 4/3/ Retired Major revision 12/28/2016 1/31/2017 2/3/ Retired Minor revision 7/29/2016 7/29/2016 1/31/ Retired Minor revision 7/13/2016 7/22/2016 7/29/ Retired Minor revision 6/2/2016 6/11/2016 7/22/ Retired Major revision 11/30/2015 1/20/2016 6/11/ Retired Minor revision 9/14/2015 9/24/2015 1/20/ Retired Minor revision 8/21/2015 8/21/2015 9/24/ Retired First version in Document Control 3/9/2015 3/9/2015 8/21/2015 Linked Documents ATL GP Gen Procedure Manual

3 1 Serum/Plasma Test AKI Risk Score (Acute Kidney Index) less than 0.3 No units 0DY: M: YR: g/dl Albumin Alkaline Phosphatase 0DY: 1M: 1YR: 10YR: 15YR: less than 310 less than 360 less than 290 less than Male: Female: ALT (Alanine Aminotransferase) 1M 14 YR: YR: 9 33 Ammonia IU/L IU/L µmol/l AST (Aspartate Aminotransferase) IU/L Amylase less than 65 IU/L Bilirubin, Direct Bilirubin, Total 0DY: M: YR: BUN (Blood Urea Nitrogen) 0DY: YR: 8 26 Calcium 0DY: M: YR: Creatinine 0DY: YR: YR: Chloride mmol/l CO mmol/l Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 1 of 24

4 Serum/Plasma Test 2 (Carbon dioxide) Glucose Fasting Glucose (less than 1 month) 0DY: 7DY: 2YR: 15YR: Magnesium Phosphorus Potassium DY: M: YR: YR: DY: 1M: 1YR: 15YR: mmol/l Sodium mmol/l Uric Acid 0DY: YR: YR: YR: YR: Male: O DY:less than121 1YR:less than45 15YR: Less than or equal to 65 IU/L GTP (gamma glutamyl transferase) Female: 0DY:less than121 1YR:45 15YR:Less than or equal to 40 Total Protein Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 2 of 24 0DY: M: YR: YR: g/dl

5 3 Serum/Plasma Test Lipase U/L Less than or equal to 200 IU/L CK-MB (Creatine Kinase-MB) 0-5 ng/ml Lactate (plasma) mmol/l Total CPK (Creatine phosphokinase) LDH (Lactate dehydrogenase) 0D -: less than 450 1M less than250 1Y less than171 U/L Iron Male: Female: µg/dl Transferrin TIBC µg/dl Ferritin ng/ml Folate greater than 5.0 ng/ml RBC Folate ng/ml Vitamin B pg/ml Troponin I less than 0.1: Normal : Borderline elevation, 0.2 Clinical significance uncertain. ng/ml (Red blood cell Folate) greater than or equal to 0.50 Elevated Troponin, suggestive of myocardial injury Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 3 of 24

6 Serum/Plasma Test 4 (Brain natriuretic peptide) less than 100 pg/ml CRP less than 0.75 hs-crp less than less than 5.0 miu/ml BNP (high sensitivity C-reactive peptide) Total ßhCG (beta subunit of human chorionic gonadotropin) #AFP (Alpha fetal protein) CEA (Carcinoembryonic Antigen) Newborn: less than M: less than 400 3M: less than 30 6M - Adult: less than 20 less than 5 = CA 15-3 ng/ml ng/ml U/ml (Cancer Antigen {breast} 15-3) less than 30 CA 19-9 less than 33 U/ml less than 35 U/ml ng/ml Complement C Complement C (Cancer Antigen {GI} 19-9) CA 125 (Cancer Antigen 125) Total PSA (Prostate-specific antigen) Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 4 of 24

7 Serum/Plasma Test Cortisol Adults: 8-10 AM: PM 2 14 μg/dl Post ACTH Stimulation Peak greater than 20 Peak after IM injection greater than 16 Child AM: 0-7D: D- 12M: YR 17YR: 6 22 ACTH Stimulation 1-12M Greater than 1Y Greater than 6Y FSH (Follicle-stimulating Hormone) 6Y 12Y Baseline Tanner II-III Males Females Tanner IV-V Males Females Min Females 2WKS: M: M: YR: YR: YR: YR: Follicular: Midcycle peak: Luteal: Postmenopausal: Tanner stages I: ; II: ; III: ; IV: ; V: Males 2WKS: M: M: YR: YR: YR: YR: YR: Tanner stages I: ; II: ; III: ; IV: 15 40; V: Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 5 of 24 miu/ml 5

8 Serum/Plasma Test LH (Luteinizing Hormone) Females Cord blood: WKS: M: M: YR: YR: YR: YR: Follicular phase: Midcycle peak: Luteal phase: Postmenopausal: Tanner stages I: ; II: ; III: ; IV: ; V: miu/ml Males Cord blood WKS M M YR YR YR YR YR Tanner stages I: ; II: ; III: ; IV: ; V: ^Haptoglobin Prealbumin Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 6 of M-1M: M-6M: M: YR: YR: YR: YR:

9 7 Serum/Plasma Test ^IgA (Immunoglobulin A) 0DY: 0 8 1M: M: M: M: M: M: YR: YR: YR: YR: YR: ^IgG (Immunoglobulin G) ^IgM (Immunoglobulin M) Progesterone 0DY: M: M: M: M: M: M: YR: YR: YR: YR: YR: DY: M: M: M: M: M: M: YR: YR: YR: YR: YR: Females: Follicular phase: Luteal phase: Mid Luteal: Pregnancy: 1st trimester: nd trimester: rd trimester: nmol/l Males: Prolactin Males: Females: Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 7 of 24 ng/ml

10 Serum/Plasma Test ^Testosterone Males: Females: less than 2.8 Female nmol/l Thyroglobulin #Thyroglobulin antibody *Total T3 (PUH) (Triiodothyronine) #Free T4 (analog-puh) ng/ml Less than 20 IU/mL Female Male 0D: M: YR: YR: YR: YR: YR: ^Total T3 (SHY) Total T4 (Thyroxine) Newborn: DY: M: YR: YR: YR: Euthyroid Hypothroid less than 0.89 Hyperthyroid greater than 1.78 Normal Range Median Females:1st Trimester Nd Trimester rd Trimester FTI (Free Thyroid Index) {a calculation} T7 (SHY) *T Uptake (PUH) (Thyroid Hormone Binding Ratio) 5 12 ng/ml ng/dl μg/dl ng/dl No units No units ^T3 Uptake (SHY) No units TSH (Thyroid Stimulating Hormone) 0DY: DY: DY: DY: M: YR: µiu/ml Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 8 of 24

11 Serum/Plasma Test Acetaminophen Therapeutic: Hepatotoxic: 4 hours post ingestion: greater than 150 µg/ml ^Salicylate Therapeutic: mg/dl Carbamazepine μg/ml Digoxin ng/ml Gentamicin Peak Level: Trough Level: Lithium Methotrexate None established Phenobarbital Phenytoin (Dilantin) 0DY-1yr 1yr-Adult Free Phenytoin μg/ml mmol/l μg/ml μg/ml μg/ml Peak: Trough: μg/ml Valproic acid Peak: μg/ml Vancomycin Trough: μg/ml VLDL (Very Low Density Lipoprotein) {a calculation} less than or equal to 40 Osmolality mosm/kg ^Tobramycin (SHY) Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 9 of 24

12 Cerebrospinal Fluid (CSF) Test CSF Glucose CSF Lactate mmol/l CSF Protein Urine Drugs of Abuse Test 0DY-1M 1M-Adult ^Benzodiazepines ^Amphetamines ^Benzoylecgonine (Cocaine Metabolite) ^Barbiturates ^Opiates ^Phencyclidine (PCP) Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 10 of 24 10

13 Urine Test Urine Albumin Albumin/ Creatinine ratio less than 1.9 less than 30 mg/g creatinine Urine Urea Nitrogen mg/24 hr Urine Calcium mg/24 hr Urine Phosphorus mg/24 hr Urine Uric Acid mg/24 hr Urine Sodium mmol/24hr Urine Potassium mmol/24hr Urine Amylase less than or equal to 30 IU/2 hr Urine Creatinine Female: Male: mg/24 hr Creatinine Clearance Female: 88 to 128 Male: 97 to 137 ml/min Urine/Serum ßhCG Male: Non-pregnant Female: Pregnant Female: Positive Urine Osmolality mosm/kg Urine Total Protein mg/24 hr *UPMC Presbyterian Hospital specific reference range ^UPMC Shadyside Hospital specific reference range # Testing performed at UPMC Presbyterian Immunoserology laboratory Testing performed at UPMC CHP Automated Testing laboratory Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 11 of 24 11

14 Urine Test Urine Color Yellow Urine Character Clear Urine Specific Gravity Urine ph Urine Protein Urine Glucose Urine Ketone Urine Bilirubin Urine Blood Urobilinogen Normal Urine Nitrite Urine Leukocyte Esterase 0-5 Per HPF Urine RBCs 0-3 Per HPF Urine Epithelial Cells 0 Per HPF Urine: Bacteria None Seen Per HPF Urine: Crystals None Seen Per HPF Hyaline Casts 0 2 Per LPF Urine WBCs Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 12 of 24 12

15 Blood Gas ( Whole Blood Specimens) ph pco2 (Partial pressure of carbon dioxide) po2 (Partial pressure of oxygen) FO2HB (Fraction of oxyhemoglobin) ica (ionized Calcium) Glucose (fasting) arterial venous arterial venous mmhg mmhg arterial venous arterial venous mmol/l Glucose Less than 1 month Sodium mmol/l Potassium mmol/l Lactate (whole blood) mmol/l COHb (Carboxyhemoglobin) Non Smokers: Smokers 1-2 pks: 4 5 Smokers less than 2 pks: 8 9 MetHb (Methemoglobin) thb (total Hemoglobin) Male Female g/dl arterial venous mq/l HCO3 (Bicarbonate) Base Excess/Base Deficient 0±2 No units O2 saturation (Oxygen saturation) arterial venous Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 13 of 24 13

16 a-vo2 Diff (arteriovenous oxygen difference) 4 6 VOL O2 Content (Oxygen content) arterial venous VOL Creatinine Chloride mmol/l References: 1. Henry s Clinical Diagnosis and Management by Laboratory methods 22nd Edition McPherson and Pincus et al. 2. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics-E-Book by Carl A. Burtis, Edward R. Ashwood, David E. Bruns 3. Kaplan et al. 4th edition. Clinical Chemistry Theory, Analysis Correlation (pg 466) Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 14 of 24 14

17 Lipoprotein s for Adult Population (Age >/=20). National Cholesterol Education Program, ATP III Classification Triglyceride () less than 150 Clinical interpretation Borderline High High Greater than or equal to 500 Very High Total Cholesterol () less than Greater than or equal to 240 Clinical interpretation Desirable Borderline High High HDL () Clinical interpretation less than 40 Greater than or equal to 60 Low High LDL () Clinical interpretation less than100 Optimal; lower LDL-C may be desirable in high risk patients Near Optimal/Above Optimal; risk factor evaluation should guide interventions Borderline High; risk factor evaluation should guide interventions Normal High; risk factor evaluation should guide interventions Greater than or equal to 190 Very High References: NCEP Guidelines: Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 15 of 24 15

18 16 Pediatric Lipid s For Cardiovascular Disease Risk Category Acceptable Borderline High Risk High Risk Total Cholesterol (2-19 years) less than Greater than or equal to 200 LDL- Cholesterol (2-19 years) less than Greater than or equal to 130 HDL- Cholesterol (2-19 years) Greater than less than years less than Greater than or equal to years less than Triglycerides References: Values for plasma lipid and lipoprotein levels are from the National Cholesterol Education Program (NCEP) Expert Panel on Cholesterol Levels in Children. The cutpoints for high and borderline high represent approximately the 95th and 75th percentiles, respectively. Low cutpoints for HDL C represent approximately the 10th percentile. From the American Academy of Pediatrics. Lipid Screening and Cardiovascular Health in Childhood. Daniels SR, Greer FR and the Committee on Nutrition. PEDIATRICS 122: , (doi: /peds ) Smoak et al. Relation of obesity to clustering of cardiovascular disease risk factors in children and young adults. The Bogalusa Heart Study. Am J Epidemiol 1987;125(3): (PM: ) Chen et al. Association of cardiovascular risk factor clustering related to insulin resistance syndrome (Syndrome X) between young parents and their offspring: the Bogalusa Heart Study. Atherosclerosis1999;145(1): (PM: ) Sinaiko et al. Relation of insulin resistance to blood pressure in childhood. J Hypertens 2002;20(3): (PM: Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 16 of 24

19 Hematology Test Hemoglobin Male: Female: g/dl Hematocrit Male: Female: WBC x /L RBC Male: Female: x /L MCV fl MCH pg MCHC g/dl MPV fl RDW POLYs BANDs 0 5 LYMPHs MONOs 4 13 EOS 0 6 BASOS 0 1 Myelocytes 0 Meta Myelocytes 0 Promyelocytes ABS Poly X10E+09/L ABS Lymphocytes X10E+09/L ABS Monocytes X10E+09/L ABS Eosinophils X10E+09/L ABS Basophils X10E+09/L ABS Bands X10e+09/L ABS Myelocytes 0 X10e+09/L Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 17 of 24 17

20 ABS Metamyelocytes 0 X10e+09/L ABS Promyelocytes 0 X10e+09/L ABS Blasts 0 X10e+09/L Reticulocyte X /L Greater than or equal to 18 yr Male: 023 Female: 0-40 less than 18 yr Male: 0-18 Female: 020 mm/hr Sickle Cell Screen Monospot Gastric Occult Occult Blood Fluid Crystals Absolute Reticulocyte Westergren Sed Rate Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 18 of 24 18

21 Synovial Fluid: Appearance RBCs Nucleated Cells Neutrophils Lymphocytes Monocytes Mononuclear cells Yellow, clear, or slightly cloudy /mm3 /mm3 Pleural Fluid: Nucleated Cell Count Macrophages Lymphocytes Neutrophils Mesothelial Cells /mm3 Peritoneal Dialysate Fluid: Red Blood Cells Total Nucleated Cells Leukocytes Neutrophils Lymphocytes Monocytes Eosinophils Basophils 24 ± 48* 36 ± 48* 21 ± ± ± ± 26 7±7 3±2 /µl /µl /µl Cerebrospinal Fluid: Gross Appearance Supernatant RBCs Nucleated Cells Lymphocytes Monocytes Histiocytes Neutrophils Clear Colorless ( ) 3 37 ( ) Rare 0 2 ( ) BAL Fluid: Alveolar macrophages Lymphocytes Neutrophils Eosinophils > less than3 less than1 Results expressed as mean ± SD No Definitive s determined for peritoneal, amniotic and pericardial fluids Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 19 of 24 /mm3 /mm3 19

22 WBC DIFFERENTIAL COUNT () POLY BANDS EOS BASO AGE 20 LYMPHS MONOS 18 years and older years up to 18 years years up to 17 years years up to 12 years years up to 6 years months up to 2 year month up to 6 months week up to 1 month day up to 1 week RETIC NORMAL VALUES RETIC AGE ABSOLUTE RETIC (X 1012/L) NORMAL RANGE NORMAL RANGE Unavailable Unavailable Unavailable Unavailable Newborn (0 days) Newborn to 5 days 6 days to 49 days 50 days to 84 days RETIC ABSOLUTE RETIC (X 1012/L) 85 days through adulthood MALE Manual Automated FEMALE MALE Immature Reticulocyte Fraction PLATELET COUNT Adults /L Children 0 31 days 32 days 18 yrs x 109L x 109/L Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 20 of 24 FEMALE

23 Hematology Test Fibrinogen D-dimer FDP Closure Time Less than 0.45 Collagen/ADP Collagen/EPI µg/ml FEU n/a Seconds Seconds INR 0 1m 1 m 16 y 16 y and older Prothrombin Time less than 1 month 1 month to 16 years Greater than 16 yrs Partial Thromboplastin Time less than 1month 1 month to 16 years Greater than 16 years ^Thrombin Time Aspirin Response Plavix Response LMW Heparin UF Heparin Acetone Lamellar Body Count (LBC) 21 less than No established reference range seconds No established reference range seconds seconds ARU ARU Base PRU Call Pharmacy Call Pharmacy negative Mature greater than or equal to 40 x 109/L Immature less than or equal to 20 x 109/L Kleihauer Betke: Fetal HGB Fetal Bleed less than 0.04 less than 2.00 Fetal APT Test ^UPMC Shadyside Hospital specific reference range Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 21 of 24 Seconds Non-therapeutic baseline Therapeutic response to aspirin Normal Baseline Range Iµ/ml Iµ/ml 109/L 109/L ml

24 AGE WBC RANGE 109/L 1 DAY UP TO 1 WEEK WEEK UP TO 2 WEEKS WEEKS UP TO 4 WEEKS WEEKS UP TO 2 MONTHS MONTHS UP TO 3 MONTHS MONTHS UP TO 6 MONTHS MONTHS UP TO 2 YEARS YEARS UP TO 6 YEARS YEARS UP TO 12 YEARS YEARS UP TO 18 YEARS YEARS TO ADULT AGE 1 DAY UP TO 1 WEEK 1 WEEK UP TO 2 WEEKS 2 WEEKS UP TO 4 WEEKS 4 WEEKS UP TO 2 MONTHS 2 MONTHS UP TO 3 MONTHS 3 MONTHS UP TO 6 MONTHS 6 MONTHS UP TO 2 YEARS 2 YEARS UP TO 6 YEARS 6 YEARS UP TO 12 YEARS 12 YEARS UP TO 18 YEARS 18 YEARS TO ADULT 22 HGB HCT RBC MCV MCH MCHC Female Male Female Male Female Male Female Male Female Male Female Male Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 22 of 24

25 23 Changes/Updates/Modifications 02/11/04 01/20/05 02/8/06 03/12/07 Revised Revised Revised Barbara Hill (B.H.) Magnesium unit change; updated Automated Testing/2006 Adult Ref Ranges/ Hem Pediatric; BH 01/22/08 PT adult range changed; BH/WJW 08/08/08 New D-dimer ref range; BH 10/14/08 Lipase reference range and unit changed; BH 03/06/09 PT reference range changed; LMW /UFH assay added; BH New Beckman instrumentation implemented; BH 08/11/09 Estradiol reference range modified; Added Creatinine Clearance and INR reference range; Octavia Peck Palmer (OPP) 01/14/2010 Revised; OPP 01/21/2010 Added Ref Ranges for Blood Gases; Jeff Bycura (JB)/Pat Kress (pk) 02/10/2011 Revised; Katie Mulvey (KM)/pk Added Aspirin and Plavix Response; Betty Austin (BA/pk) 03/2011 Changed TgAb reference range from less than or = 4.0 to less than 20 because TgAb testing was moved to immunoserology laboratory; OPP 10/2011 Added urine albumin reference ranges, removed urine glucose; OPP 02/07/2013 Added > to TC = 500; Changed optimal to normal for TG less than150; Changed levels to concentrations in lipid section; OPP 02/25/2013 Added Absolute counts for Hematology differentials; Lydia Contis (LC) and KM 12/19/2013 Added Myelocytes, ABS Myelocytes, Meta Myelocytes, ABS Meta Myelocytes, Promyelocytes, ABS Promyelocytes, Blasts, ABS Blasts; Lydia Contis 12/23/13 Changes made to reference range for Amylase, Lipase, Urine Amylase; KM for OPP Added reference ranges to Prothrombin Time and Partial Thromboplastin Time; KM for Lydia Contis 1/14/14 Added reference ranges to Hematology LMW & UF Heparin; KM for Lydia Contis Added reference ranges to Hematology INR; KM for Lydia Contis 6/16/14 Change made to Troponin I on page 3; KM/OPP 9/17/14 Changed CK-MB reference to 0 5 ng/ml (old reference range was TCPK less than or equal to 200: MB less than or equal to 7 TCPK greater than 200: RI less than or equal to 3; OPP 12/08/14 Added Pediatric Lipid for Cardiovascular Disease Risks; OPP 12/08/14 Removed Pediatric commentary in Lipid sections; OPP 1/07/2015 Revised Adult lipid section into Tables and added the title; OPP Added Creatinine Clearance RR; removed units from RR column to Unit Column;OPP 01/12/15 Added LDH Pediatric Reference ranges; OPP Added Methotrexate performed by SHY ATL; OPP Added Urine Drugs of Abuse tests performed by SHY ATL;OPP Added Acetaminophen and Salicylate tests performed by SHY ATL:OPP 09/14/15 Added Acetone; KM Added Lamellar Body Count (LBC); KM 11/23/15 PT, APTT, Fibrinogen reference range changes 12/16/2015 Chemistry test complete names added in addition to abbreviations; calculated values and not direct values for test were noted;opp Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 23 of 24

26 4/18/2017 pco2, po2 and Bicarbonate reference range changes. Controlled copy ID Printed on 5/18/2017 1:58 PM (EDT). Page 24 of 24 24