Glycols (Ethylene and Propylene)
| Order Code: | GLYCOL |
| Epic Lab Code: | LAB615 |
| Order Form: | A-1a Miscellaneous Request or Epic Req |
Chemistry
6240 RCP
356-3527
6240 RCP
356-3527
Specimen:
Plasma
Collection Medium:
 |
| Plasma Separator Tube |
Alternate
Collection Media:
Call laboratory for additional acceptable specimen collection containers.
Minimum:
3 mL whole blood from light green top tube or TWO microtainers for
pediatric patients
Rejection Criteria:
Medico-legal specimens are not accepted.
Testing Schedule:
0700-1530 Monday through Friday. For additional services,
contact Clinical Pathology Resident on-call at pager #3404.
Analytic Time:
4 hours (upon receipt in laboratory)
Reference Range:
Ethylene glycol toxicity usually >50 mg/dL
Clinical toxicity: >10 mg/dL
Propylene glycol toxicity range not well defined but clinical toxicity more likely if plasma concentration exceed 100 mg/dL.
Critical values:
Ethylene glycol 10 mg/dL or greater
Propylene glycol 100 mg/dL or greater
(NOTE: for patients admitted to the hospital who get multiple glycols plasma concentrations by gas chromatography, only the first plasma concentration exceeding the values above are treated as critical values, i.e., follow-up levels are not called as critical values to the ordering clinician).
Clinical toxicity: >10 mg/dL
Propylene glycol toxicity range not well defined but clinical toxicity more likely if plasma concentration exceed 100 mg/dL.
Critical values:
Ethylene glycol 10 mg/dL or greater
Propylene glycol 100 mg/dL or greater
(NOTE: for patients admitted to the hospital who get multiple glycols plasma concentrations by gas chromatography, only the first plasma concentration exceeding the values above are treated as critical values, i.e., follow-up levels are not called as critical values to the ordering clinician).
Comments:
This test requires approval of Clinical
Pathology Resident on-call (pager #3404).
Note that the "Ethylene Glycol, Plasma" provides more rapid determination of ethylene glycol plasma concentrations. The "Ethylene Glycol, Plasma" test is reflexively ordered if the unexplained osmolar gap is greater than 15 and may also be directly ordered in cases of suspected ethylene glycol ingestion or for monitoring ethylene glycol plasma concentrations in patients receiving treatment for ethylene glycol ingestion. This procedure individually quantitates ethylene glycol.
The glycols by gas chromatography tests may be ordered if there is an interference with the "Ethylene Glycol, Plasma" test or if quantitation of propylene glycol is needed. This procedure individually quantitates ethylene glycol and propylene glycol. Ethylene glycol is commonly found in many automobile antifreezes. Propylene glycol is found in some intravenous drug formulations as a solvent/diluent (e.g., diazepam, lorazepam, etomidate, and phenytoin) and is also found in a small number of automobile antifreezes (e.g., Sierra).
References:
Wilson KC, Reardon C, Theodore AC, and Farber HW. Propylene glycol toxicity: a severe iatrogenic illness in ICU patients receiving IV benzodiazepines: a case series and prospective, observationl pilot study. Chest 128: 1674-1681, 2005.
Eder AF et al. Ethylene glycol poisoning: toxicokinetic and analytical factors affecting laboratory diagnosis. Clin Chem 44: 168-177, 1998.
Profile result codes: GLYC, PGLY
Note that the "Ethylene Glycol, Plasma" provides more rapid determination of ethylene glycol plasma concentrations. The "Ethylene Glycol, Plasma" test is reflexively ordered if the unexplained osmolar gap is greater than 15 and may also be directly ordered in cases of suspected ethylene glycol ingestion or for monitoring ethylene glycol plasma concentrations in patients receiving treatment for ethylene glycol ingestion. This procedure individually quantitates ethylene glycol.
The glycols by gas chromatography tests may be ordered if there is an interference with the "Ethylene Glycol, Plasma" test or if quantitation of propylene glycol is needed. This procedure individually quantitates ethylene glycol and propylene glycol. Ethylene glycol is commonly found in many automobile antifreezes. Propylene glycol is found in some intravenous drug formulations as a solvent/diluent (e.g., diazepam, lorazepam, etomidate, and phenytoin) and is also found in a small number of automobile antifreezes (e.g., Sierra).
References:
Wilson KC, Reardon C, Theodore AC, and Farber HW. Propylene glycol toxicity: a severe iatrogenic illness in ICU patients receiving IV benzodiazepines: a case series and prospective, observationl pilot study. Chest 128: 1674-1681, 2005.
Eder AF et al. Ethylene glycol poisoning: toxicokinetic and analytical factors affecting laboratory diagnosis. Clin Chem 44: 168-177, 1998.
Profile result codes: GLYC, PGLY
Methodology:
Gas Chromatography
CPT Code:
84600
See Additional Information:
Chemistry Critical Lab Values
Osmolality Gap - Calculation and Interpretation
Osmolality Gap Calculator
Chemistry Critical Lab Values
Osmolality Gap - Calculation and Interpretation
Osmolality Gap Calculator