DTH Meditech HCIS Reference Intervals

Transcription

1 Applicability Purpose This document applies to all Central Zone DTH Meditech HCIS personnel of AHS Laboratory Services and laboratories administered under the Covenant Health Group collectively referred to here as Laboratory Services. This document states the reference intervals for Central Zone DTH Meditech HCIS Laboratory analytes. Test ACETAMINOPHEN, P/S ALBUMIN/CREATININE RATIO, U ALBUMIN, P/S ALBUMIN, TIMED, 24 Hour Urine ALKALINE PHOSPHATASE (ALP), P/S Reference Intervals MALE AND µmol/l yr Therapeutic MALE AND mg/mmol <1 mo < mo 1 yr < yr <3.00 MALE AND g/l 0 <1 mo mo 11 mo yr 150 yr Urine Albumin Excretion Rate MALE AND ug/min yr <20 MALE AND U/L 0 <1 mo mo 8 yr yr yr MALE 9 11 yr yr yr yr ALANINE AMINOTRANSFERASE (ALT), P/S AMMONIA, P 9 10 yr yr yr MALE AND U/L yr <50 MALE AND µmol/l 0 <1 mo mo 14 yr yr Initials: Site: Date Printed: Page 1 of 18

2 AMYLASE, 24 Hour Urine AMYLASE, U AMYLASE, P/S ANA or FANA (NUCLEAR ANTIBODY SCREEN), S ANTISTREPTOLYSIN O, P/S ASPARTATE AMINOTRANSFERASE (AST), P/S BETA HUMAN CHORIONIC GONADOTROPIN (BCHG), U BETA HUMAN CHORIONIC GONADOTROPIN (BHCG), P/S BETA-HYDROXYBUTYRATE, B BILIRUBIN DIRECT, P/S BILIRUBIN TOTAL, P/S BILIRUBIN NEONATAL, S BLOOD GASES BNP (B-TYPE NATRIURETIC PEPTIDE), P CALCIUM, 24 Hour Urine MALE AND U/d yr < 450 MALE AND U/L yr < 135 MALE AND U/L 0 <1 mo < 25 1 mo 11 mo yr MALE AND ku/l yr <200 MALE AND U/L 0 1 yr yr yr yr 7 40 MALE AND IU/L yr < yr MALE AND µmol/l yr < 5 MALE AND µmol/l 0 <1 mo < mo 150 yr < 21 MALE AND µmol/l 0 <1 mo < 121 Refer to tables on the last page of this document MALE AND ng/l yr Diagnostic Criteria: <100 CHF Unlikely CHF Possible >500 CHF Likely MALE AND mmol/d yr < 7.50 (intake dependent) Initials: Site: Date Printed: Page 2 of 18

3 CALCIUM, P/S 0 10 d d 11 yr yr CALCIUM IONIZED, POST FILTER yr CALCIUM, IONIZED, S yr CARBAMAZEPINE, P/S MALE AND µmol/l Therapeutic Range yr CBC (COMPLETE BLOOD COUNT), B See "DTH Meditech HCIS CBC and Differential Reference Intervals CELL COUNT, CSF Color Colorless Appearance Clear WBC 0 5 x10 6 /L RBC 0 x 10 6 /L CELL COUNT, Fluid Transudates Color Colorless Clarity Clear RBC < 10,000 x 10 6 /L WBC < 1,000 x 10 6 /L CHLAMYDIA/GONORRHOEAE PROBE NUCLEIC ACID AMPLIFICATION TEST (NAAT) CHOLESTEROL, TOTAL, P/S Exudates Color Variable Clarity Turbid RBC > 10,000 x 10 6 /L WBC > 1,000 x 10 6 /L MALE AND : mmol/l <=1 yr >1 17 yr The following comment will be attached to the result: Acceptable limit relative to dyslipidemia and atherosclerosis risk is < 4.40 mmol/l yr No reference range CLOSTRIDIUM DIFFICILE The following comment will be attached to the result: Desirable < 5.17 mmol/l High >= 6.21 mmol/l Initials: Site: Date Printed: Page 3 of 18

4 CO-OXIMETRY CREATINE KINASE (CK), P/S Refer to tables on the last page of this document MALE AND U/L 0 <1 mo < mo < 280 MALE 3 mo 17 yr < yr < 165 CREATINE KINASE MB (CKMB), P/S CKMB/CK RATIO, P C-REACTIVE PROTEIN (CRP), P/S CREATININE, 24 Hour Urine CREATININE, P/S 3 mo 17 yr < yr < 140 MALE AND ug/l 0 150yr AMI criteria >5.0 MALE AND yr AMI Criteria > MALE AND mg/l yr 0 10 MALE mmol/d yr yr MALE,, Unknown umol/l 0 1 yr yr yr yr MALE/Unknown yr CREATININE CLEARANCE, 24 Hour Urine + P/S yr MALE AND ml/s 0 1 yr MALE 2 59 yr yr yr yr Initials: Site: Date Printed: Page 4 of 18

5 CRYOGLOBULIN, S D-Dimer, Quantitative, P D-DIMER QUANTITATIVE (Triage Meter), B DIFFERENTIAL, B DIGOXIN, P/S < 243 ng/ml A D-Dimer BELOW the 230 ng/ml cutoff may be used with a standardized CLINICAL ASSESSMENT and/or imaging studies to help exclude venous thromboembolism (VTE). Values ABOVE the 230 ng/ml cutoff are not diagnostically useful in VTE assessment. 0.5 mg/l A D-Dimer level BELOW the 0.5 mg/l cutoff may be used with the standardized clinical assessment and/or imaging studies to help exclude venous thromboembolism (VTE). Values above the cutoff are not diagnostically useful in VTE assessment. See "DTH Meditech HCIS CBC and Differential Reference Intervals MALE AND nmol/l yr Suggested Ranges: Heart failure Atrial Fibrillation Not Defined DNA DOUBLE STRAND ANTIBODY, S egfr (CKD-EPI) Caution: Results > 1.5 nmol/l are associated with a higher risk of toxicity in heart failure patients. The following Interpretive Comment will be appended to all egfr results on adults (>18 years) with egfr results <60 ml/min/1.73 m 2. "egfr <60 ml/min/1.73 m 2 or urine Albumin/creatinine ratio >3.00 mg/mmol for more than 3 months suggests chronic kidney disease. For information on diagnosis, management and referral see The following Interpretive Comment will be appended to all egfr results on adults (>18 years) Reduced muscle mass will lead to overestimation, and increased muscle mass underestimation of egfr. egfr results will not be reported on patients <18 years of age or dialysis patients. Initials: Site: Date Printed: Page 5 of 18

6 ELECTROLYTES, P/S Sodium 0 <1 mo mo yr Potassium 0 <1 mo mo yr Chloride 0 <1 mo mo 150 yr ELECTROLYTES, 24 Hour Urine CO2 0 <1 mo mo 11 mo yr MALE AND mmol/d Intake dependent Sodium 0 <1 mo mo 150 yr Potassium yr ESR (ERYTHROCYTE SEDIMENTATION RATE), B ETHANOL, P/S Chloride 0 11 mo yr yr yr 0 10 mm/h yr 0 20 mm/h MALE yr 0 15 mm/h yr 0.0 Legal Limit 17.4 Initials: Site: Date Printed: Page 6 of 18

7 FERRITIN, P/S MALE AND µg/l 0 <1 mo mo mo mo 15 yr MALE yr yr yr FIBRINOGEN, QUANTITATIVE, P g/l FOLATE, P/S MALE AND nmol/l yr FSH (FOLLICLE STIMULATING HORMONE), P/S MALE U/L yr yr < yr Follicular: U/L Midcycle: U/L Luteal: U/L Post-Menopausal: On Menopausal Hormone Therapy (MHT) Not on MHT U/L GAMMA-GLUTAMYL TRANSFERASE (GGT), P/S MALE AND U/L 0 <1 mo mo mo mo mo yr 17 yr MALE yr GENTAMICIN INTERVAL, P/S GENTAMICIN PEAK, P/S GENTAMICIN RANDOM, P/S yr No range. MALE AND mg/l Therapeutic Range yr No range. Initials: Site: Date Printed: Page 7 of 18

8 GENTAMICIN TROUGH, P/S GLUCOSE, CSF GLUCOSE FASTING, P/S GLUCOSE RANDOM, P/S GLUCOSE GESTATIONAL DIABETIC SCREEN, P/S GLUCOSE GESTATIONAL TOLERANCE TEST, P/S GLUCOSE TOLERANCE TEST 2 h, P/S MALE AND mg/l Therapeutic Range yr < yr < 30 d d 150 yr d d 150 yr Gestational Diabetic Screen Interpretive Guidelines (Canadian Diabetes Guidelines 2013): Normal: < 7.8 mmol/l Follow-up with GTT-2h Pregnant: mmol/l Gestational Diabetes: >= 11.1 mmol/l Gestational Glucose Tolerance Test Interpretive Guidelines (Canadian Diabetes Guidelines (2013)): Gestational Diabetes Mellitus - glucose results meet ONE of the criteria below: Fasting: >= 5.3 mmol/l 1h Glucose: >= 10.6 mmol/l 2h Glucose: >= 9.0 mmol/l Glucose Tolerance Test Interpretive Guidelines (Nonpregnant; Canadian Diabetes Guidelines (2013)): Normal Glucose Tolerance: Fasting Glucose: AND 2h Glucose mmol/l < 7.8 mmol/l Impaired Fasting Glucose and Impaired Glucose Tolerance: Fasting Glucose: mmol/l AND 2h Glucose mmol/l HEMOGLOBIN A1c (GLYCOSYLATED HGB), B Diabetes Mellitus: Fasting Glucose: > 6.9 mmol/l OR 2h Glucose > 11.0 mmol/l MALE AND yr % < 6 years Recommended target: HbA1c less than 8% for children less than 6 years. Initials: Site: Date Printed: Page 8 of 18

9 2013 CDA Guidelines. CJD 2013:37:S years Recommended target: HbA1c less than or equal to 7.5% for children 6-12 years CDA Guidelines. CJD 2013:37:S HIV Rapid Antibody Screen, S IMMUNOGLOBULINS (QUANTITATIVE), P/S >12 years Recommended target: HbA1c less than or equal to 7.0% for males and non-pregnant females greater than 12 years CDA Guidelines. CJD 2013:37:S31-34 MALE AND Non-Reactive IgG MALE AND g/l 0 2 mo mo yr yr yr yr yr yr IgA MALE AND g/l 0 2 mo mo mo yr yr yr yr yr yr yr IgM MALE AND g/l 0 2 mo mo yr yr yr yr yr IRON, TOTAL IRON BINDING CAPACITY (TIBC), IRON µmol/l Initials: Site: Date Printed: Page 9 of 18

10 AND IRON SATURATION INDEX, S MALE AND 0 17 yr 5 25 MALE yr yr 6 28 TIBC µmol/l MALE AND 0 17 yr yr LACTATE, Arterial LACTATE, P LACTATE, CSF LACTOSE, P/S - TOLERANCE TEST - 2 h LACTATE DEHYDROGENASE (LD), P/S LUTEINIZING HORMONE (LH), P/S LIPASE, P/S IRON SATURATION INDEX: MALE AND yr mmol/l yr yr Lactose Tolerance Interpretive Criteria: Normal: Rise in glucose of >1.7 mmol/l at any time postlactose. Inconclusive: Rise in glucose of mmol/l at any time post-lactose. Abnormal (query lactase deficiency): Rise in glucose of < 1.1 mmol/l at any time post-lactose. Reference range varies with instrument. Please refer to patient report for current value(s). MALE U/L yr yr < yr Follicular: U/L Midcycle: U/L Luteal: U/L Post-Menopausal: On Menopausal Hormone Therapy (MHT) Not on MHT Reference range varies with instrument. Please refer to patient report for current value(s). Initials: Site: Date Printed: Page 10 of 18

11 LIPID PROFILE, P/S Pediatric Lipid Profile (0 17 yr) Total Cholesterol No reference range HDL-C No reference range LDL-C No reference range Triglycerides No reference range Non-HDL-C No reference range The following comment will be attached to the Non-HDL-C result: Lipid Profile acceptable limits relative to dyslipidemia and atherosclerosis risk: Total Cholesterol Acceptable <4.40 mmol/l HDL-C Acceptable >1.16 mmol/l LDL-C Acceptable <2.84 mmol/l Triglycerides Acceptable <0.85 mmol/l (0-9 years) OR <1.02 mmol/l (10-17 years) Non-HDL-C Acceptable <3.10 Adult Lipid Profile ( yr) Total Cholesterol No reference range HDL-C No reference range LDL-C mmol/l Triglycerides mmol/l Non-HDL-C mmol/l The following comment will be attached to the Non-HDL-C result: For patients 30 years of age or older, the Framingham Risk Score (FRS), modified for family history, is recommended for risk assessment (2016 CCS Guideline, Can J Cardiol 2016): FRS Calculation Resources can be found at Risk-Calculator.aspx. Low Risk (FRS < 10%) Treatment advised if LDL-C >= 5.0 mmol/l Treatment target: > 50% reduction LDL-C Intermediate Risk (FRS 10-19%) Treatment advised if LDL-C >= 3.5 mmol/l OR Non-HDL- C >= 4.3 mmol/l OR ApoB >= 1.2 g/l; Consider treatment for men>=50 and women>=60 yrs with one additional CV risk factor Treatment targets: LDL-C < 2.0 mmol/l OR decrease by > 50% OR Non-HDL-C < 2.6 mmol/l OR ApoB < 0.8 g/l Initials: Site: Date Printed: Page 11 of 18

12 High Risk (FRS >= 20% or presence of high risk features) Treatment advised in all patients LITHIUM, S MAGNESIUM, 24 Hour Urine MAGNESIUM, P/S MALARIAL PARASITE SCREEN, B MONONUCLEOSIS TEST, S OCCULT BLOOD, F OSMOLALITY, P/S OSMOLALITY, Sweat OSMOLALITY, U Treatment targets: LDL-C < 2.0 mmol/l OR decrease by > 50% OR Non-HDL-C < 2.6 mmol/l OR ApoB < 0.8 g/l yr Suggested Range: Acute Mania Therapy Bipolar Maintenance Therapy MALE AND mmol/d yr < <1 mo mo 8 yr yr yr MALE AND mmol/kg yr MALE AND mmol/kg 0 12y Reference Range: Borderline range: Suggestive of cystic fibrosis: MALE AND mmol/kg Random: 0 11 mo yr h Urine: yr After 12 h fluid restriction: yr > 850 ph, Arterial Cord Blood ph ph, Venous Cord Blood ph PHENOBARBITAL, P/S MALE AND µmol/l Therapeutic Range yr PHENYTOIN, P/S MALE AND µmol/l Therapeutic Range yr Initials: Site: Date Printed: Page 12 of 18

13 PHOSPHATE, 24 Hour Urine PHOSPHATE, P/S PROLACTIN, P/S MALE AND mmol/d Intake Dependent 0 11 yr < yr < 50 0 <1 mo mo yr yr yr MALE ug/l 1 mo 150 yr ug/l yr Non-Pregnant Pregnant Post-Menopausal PROTEIN TOTAL, 24 Hour Urine MALE AND g/d yr < 0.15 PROTEIN TOTAL, CSF MALE AND g/l 0 <1 mo mo 150 yr PROTEIN TOTAL, P/S MALE AND g/l 0 <1 mo mo yr yr yr yr PROTEIN TOTAL, U MALE AND g/l yr < 0.15 PROTEIN CREATININE RATIO, U MALE AND mg/mmol y < 13.0 PT (PROTHROMBIN TIME), INR, P Therapeutic Range: NOTE: For some indications a higher target therapeutic range is required. Reference: February 2012, 141(2_suppl) Antithrombotic Therapy and Prevention of Thrombosis, 9 th ed: American College of Chest Physicians Evidence-Based Practice Guidelines. PTT (PARTIAL THROMBOPLASTIN TIME), P Reference Range and Therapeutic Range varies with instrument. Please refer to patient report for current value. Initials: Site: Date Printed: Page 13 of 18

14 RETICULOCYTE COUNT, B RELATIVE (%): 0 1 mo mo 11 y y 150 yr (F) y 150 yr(m) ABSOLUTE: Birth x 10 9 /L 1d 1wk x 10 9 /L 1wk 1m x 10 9 /L 1m 6m x 10 9 /L 6m 5y x 10 9 /L 6y 11y x 10 9 /L 12y 17y (F) x 10 9 /L 12y 17y (M) x 10 9 /L yr (F) x 10 9 /L yr (M) x 10 9 /L RHEUMATOID FACTOR QUANTITATIVE, P/S MALE AND ku/l yr < 15 ROTAVIRUS RSV (RESPIRATORY SYNCYTIAL VIRUS) SALICYLATE, P/S yr < 0.20 Therapeutic SEMINAL FLUID ANALYSIS, FERTILITY, Semf Liquefaction Normal (complete within 60 minutes of collection) Volume > 1.4 ml Viscosity Normal (< 2 cm thread) ph > 7.1 Sperm concentration > 14.9 M/mL Total sperm count > 38.9 M RBC 0/hpf WBC 0/hpf Sperm Motility > 31% Progressive or > 39% Progressive and Non-progressive within 60 minutes of ejaculation Vitality > 57% live SEMINAL FLUID ANALYSIS, POST None seen VASECTOMY, Semf STREPTOLYSIN O ANTIBODY, P/S MALE AND ku/l yr < 200 Initials: Site: Date Printed: Page 14 of 18

15 T3 FREE, P/S THEOPHYLLINE, P/S THROMBIN TIME, P THYROXINE FREE (T4), P/S TOBRAMYCIN INTERVAL, P/S TOBRAMYCIN PEAK, P/S TOBRAMYCIN RANDOM, P/S TOBRAMYCIN TROUGH, P/S- TRIGLYCERIDE, P/S MALE AND pmol/l 4 30 d d 1 yr yr yr yr yr MALE AND µmol/l Therapeutic Range 0 <1 mo mo 150 yr Clinical cutoff varies with instrument. Please refer to patient report for current value. MALE AND pmol/l 0 13 d d 150 yr No range. MALE AND mg/l Therapeutic Range yr No range MALE AND mg/l Therapeutic Range yr < 2.0 MALE AND : mmol/l 0 17 yr < 1.50 The following comment will be attached to the result: Acceptable limit relative to dyslipidemia and atherosclerosis risk <0.85 mmol/l (0-9 years) OR <1.02 mmol/l (10-17 years). TROPONIN I (TnI), P/S TSH (THYROID STIMULATING HORMONE), P/S yr Reference range varies with instrument. Please refer to patient report for current value(s). MALE AND mu/l 0 13 d d 76 d d <1 yr yr <5 yr yr <14 yr yr Initials: Site: Date Printed: Page 15 of 18

16 TSH PROGRESSIVE (THYROID STIMULATING HORMONE), P/S URATE, 24 Hour Urine URATE, P/S MALE AND mu/l 0 13 d d 76 d d <1 yr yr <5 yr yr <14 yr yr MALE AND mmol/d yr MALE AND µmol/l 0 <1 mo mo 10 yr MALE yr yr yr UREA, 24 Hour Urine UREA, P/S URINALYSIS, U URINALYSIS MICROSCOPIC, U yr yr MALE AND mmol/d yr <1 mo mo 3 yr yr yr MALE & yr Blood: Clarity: Clear Color: Yellow Glucose: Ketone: Leukocytes: Nitrite: ph: 5 8 Protein: SG: MALE AND yr WBC: 0 5/hpf RBC: 0 2/hpf Squamous epithelial cells: 0 5/hpf Initials: Site: Date Printed: Page 16 of 18

17 VALPROATE (VALPROIC ACID), P/S VANCOMYCIN, P - RANDOM VANCOMYCIN, P - TROUGH VITAMIN B12, P/S Non-squamous epithelial cells: 0 5/hpf Bacteria & other organisms: Casts, hyaline: 0 2/lpf All other cast types: Oval Fat Bodies, Trichomonas and Yeast: MALE AND µmol/l yr Therapeutic Range NOTE: Concentrations up to 1040 µmol/l may be required for some patients with complex partial seizures and secondarily generalized tonic-clonic seizures. No range MALE AND mg/l Therapeutic Range yr MALE AND pmol/l yr > 160 Initials: Site: Date Printed: Page 17 of 18

18 Blood Gases and Co-oximetry Reference Intervals Test Name Adult / Pediatric Arterial Venous Mixed Venous Capillary ph pco 2 (mmhg) po 2 (mmhg) HCO 3 (mmol/l) tco 2 (mmol/l) Base Excess (mmol/l) - 2 to +2-2 to +2-2 to +2-2 to +2 O 2 Saturation (%) thb (g/l) O 2 Hb (%) COHb (%) MetHb (%) HHb (%) O2CT (ml/dl) Aa DO2 (mmhg) <15 Room Air < % O2 Test Name Cord Blood Arterial Cord Blood Venous Cord Blood ph pco 2 (mmhg) po 2 (mmhg) HCO 3 (mmol/l) tco 2 (mmol/l) Base Excess (mmol/l) - 8 to +2-8 to +2 O 2 Saturation (%) Initials: Site: Date Printed: Page 18 of 18