Glycols (Ethylene and Propylene) By Gas Chromatography
Label Mnemonic: GLYCOL
Epic code: LAB615
Order form: Toxic Alcohols (Glycols and Alcohols) Laboratory Requisition
Supply order: Supply Order Form
Billing: Billing Policies
CPT code: 80320
Specimen(s):
Plasma
Collection Medium:
Plasma Separator Tube 4.5 mL
Alternate Collection Media:
Call laboratory for additional acceptable specimen collection containers.
Minimum:
3 mL whole blood from light green top tube or TWO Microtainer® devices for pediatric patients
Rejection Criteria:
Medico-legal specimens are not accepted.
Testing Schedule:
This test is not run routinely and requires approval of Clinical Pathology Resident On-Call. Call 1-319-356-1616 and ask operator to page #3724 (M-F, 08:00-17:00) OR page #3404 (all other times).
Turn Around Time:
4 hours (upon receipt in laboratory)
Reference Range:
None Detected (< 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
Comments:
Note that the "Ethylene Glycol Rapid Assay (LAB7453)" provides more rapid determination of ethylene glycol plasma concentrations. The "Ethylene Glycol Rapid Assay" may be directly ordered for a known, documented ethylene glycol ingestion or when monitoring ethylene glycol plasma concentrations in a patient receiving treatment for ethylene glycol ingestion. The Ethylene Glycol Rapid Assay individually quantitates ethylene glycol.

This procedure individually quantitates ethylene and propylene glycols by gas chromatography. Prior to testing for glycols by gas chromatography, the sample will have a preliminary ethanol/volatiles screen (EVS) (LAB604) and Ethylene Glycol Rapid Assay (LAB7453) performed. An EVS includes plasma ethanol, plasma osmolality, and a calculated osmolality using plasma sodium, glucose and urea along with a rapid ethylene glycol assay. See links below for further information concerning the osmolality gap.

If ethylene glycol is present, referral laboratory is contacted by Pathology Resident On-Call or Pathology laboratory staff. All other cases are reviewed by the On-Call Pathologist.

Availability: As needed - subject to the screening procedure described above.
Methodology:
Gas Chromatography
Instructions:
Separate plasma from cells ASAP.
Sample Processing:
Centrifuge at a speed and time necessary to get barrier separation of plasma/serum and cells.
Separate plasma or serum into labeled container and cap.
Label transport tube with two patient identifiers, date and time of collection.
Sample Storage:
Refrigerate.
Transport Instructions:
Place labeled specimen into zip-lock type biohazard bag; seal bag.
Place completed requisition into outside pocket of bag.
Transport in cooler with refrigerated coolant packs.
CPT Code:
80320