Glycols (Ethylene and Propylene)
| Order Code: | GLYCOL |
| Order Form: | Laboratory Requisition |
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.
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:
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.
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) performed. An EVS includes plasma ethanol, plasma osmolality, and a calculated osmolality using plasma sodium, glucose and urea. See links below for further information concerning the osmolality gap.
Note: the osmolality gap, which is the difference between measured osmolality and calculated osmolality, must be >15 before gas chromatography testing will be initiated. An osmolality gap of < 15 will be called to the requesting facility/physician by Pathology staff to discuss our findings and determine if further testing is warranted. Alcohol testing by gas chromatography is also subject to a preliminary EVS screen.
Availability: As needed - subject to the screening procedure described above.
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) performed. An EVS includes plasma ethanol, plasma osmolality, and a calculated osmolality using plasma sodium, glucose and urea. See links below for further information concerning the osmolality gap.
Note: the osmolality gap, which is the difference between measured osmolality and calculated osmolality, must be >15 before gas chromatography testing will be initiated. An osmolality gap of < 15 will be called to the requesting facility/physician by Pathology staff to discuss our findings and determine if further testing is warranted. Alcohol testing by gas chromatography is also subject to a preliminary EVS screen.
Availability: As needed - subject to the screening procedure described above.
Methodology:
Gas Chromatography
Instructions:
Separate plasma from cells asap.
Sample
Processing:
Centrifuge at 3000 RPM for 10 minutes.
Aliquot plasma into labeled container and cap.
Label transport tube with two patient identifiers, date and time of collection.
Aliquot plasma into labeled container and cap.
Label transport tube with two patient identifiers, date and time of collection.
Sample
Storage:
Refrigerate.
Transport
Instructions:
Place requisition into outside pocket of bag.
Place specimen into zip-lock type bag, seal bag.
Transport in cooler with refrigerated coolant packs.
Place specimen into zip-lock type bag, seal bag.
Transport in cooler with refrigerated coolant packs.
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