Specimen:

Plasma

Collection Medium:

Alternate
Collection Media:

Call laboratory for additional acceptable specimen collection 
containers.

Minimum:

1 mL whole blood in light green top tube or one microtube for pediatric 
patients

Rejection Criteria:

Sodium heparin is not acceptable (elevates Na)

Testing
Schedule:

24 hrs/day, 7 days a week, including holidays.

Analytic Time:

1 hour (upon receipt in laboratory)

Reference Range:

135-145 mEq/L.  Grossly lipemic samples may give falsely low results.

Pediatric Reference Ranges:

Age        Range    Units
Premature  130-140  mEq/l

Critical value: <120 mEq/l and >160 mEq/l

Test
Limitations:

Patients over a wide anion gap range demonstrated no significant 
chloride bias from coulometric titrations. Bromide at 0.7 mmol/l gave a 
1 mmol/l chloride response (4).

Selectivity of chloride cartridge (4)(mmol/l of anion required to 
increase chloride results by 1 mmol/l)

A list of substances and conditions known to affect the level of 
sodium, potassium or chloride in vivo is given by both Young et al (5) 
and Friedman et al (6).  No representation is made by Roche Diagnostics 
regarding the completeness of these lists or the accuracy of the 
information contained therein.

References:
(1) Glick MR, Ryder KW, Glick SJ. Interferographs:Users Guide to
    Interferences in Clinical Chemistry Instruments, 2nd ed.
    Indianapolis, IN: Science Enterprises Inc; 1991:35-44.

(2) Tietz NW. Fundamentals of Clinical Chemistry. Philadelphia, Pa:
    3rd ed. WB Saunders Co; 1987:617.

(3) Tietz NW. Clinical Chemistry. Philadelphia, Pa: 2nd ed.,WB Saunders
    Co; 1994:1356, 1364, 1365.

(4) Simmons M, Sugahara K, Watanabe M. Development of an Improved
    Chloride Electrode for the Boehringer Mannheim/Hitachi 700 Series
    Analyzers. Poster session presented at the 1988 National Meeting
    of the American Association for Clinical Chemistry, New Orleans,
    LA, July 27, 1988 (reprints available from Roche Diagnostics
    Corporation).

(5) Young DS, et al. Clin Chem. 1975;21, No 5.

(6) Friedman RB, et al. Clin Chem. 1980;26, No 4.

Methodology:

Ion Selective Electrode

Sample
Processing:

Centrifuge at 3000 RPM for 10 minutes.
Aliquot plasma into labeled container and cap.

Sample
Storage:

Refrigerate.

Transport
Instructions:

Place specimen into zip-lock type bag, seal bag.
Place requisition into outside pocket of bag.
Ship ambient or refrigerate.

CPT Code:

84295

See Additional Information:
Chemistry Critical Lab Values
Chemistry Pediatric Reference Ranges