Catecholamines, Fractionated
| Label Mnemonic: | CATP |
| Epic code: | LAB2807 |
| Downtime form: | Doctor/Provider Orders - Pathology Core and Specialty Care Nursery |
6240-8 RCP
356-8593
Plasma must be separated from cells as soon as possible, within one hour of collection.
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| Green top tube 10 mL (Na Heparin) Hospital Stores #907693 |
Preferred Minimum: 10 mL Whole Blood
Absolute Minimum: 5 mL Whole Blood
EDTA plasma, serum or urine. Full 4 mL Green top Tube (Na Heparin) is NOT acceptable. Minimum specimen volume is not provided with this tube size and the order will be canceled.
After collection, place in wet ice and immediately deliver to laboratory. Critical Frozen.1-4 days upon receipt at reference laboratory
Epinephrine 2-10 days 36-400 pg/mL 11 days-3 months 55-200 pg/mL 4-11 months 55-440 pg/mL 12-23 months 36-640 pg/mL 24-35 months 18-440 pg/mL 3-17 years 18-460 pg/mL 18 years and older 10-200 pg/mL Norepinephrine 2-10 days 170-1180 pg/m 11 days-3 months 370-2080 pg/m 4-11 months 270-1120 pg/mL 12-23 months 68-1810 pg/mL 24-35 months 170-1470 pg/mL 3-17 years 85-1250 pg/m 18 years and older 80-520 pg/mL Dopamine 2 days and older: 0-20 pg/mL
Small increases in catecholamines (less than 2 times the upper reference limit) are usually the result of physiological stimuli, drugs, or improper specimen collection. Significant elevation of one or more catecholamines (2 or more times the upper reference limit) is associated with an increased probability of a neuroendocrine tumor. Measurement of plasma or urine fractionated metanephrines provides better diagnostic sensitivity than measurement of catecholamines.
Quantitative High Performance Liquid Chromatography
Specimens Requiring Immediate Delivery
Medications which may interfere with catecholamines and metabolites include amphetamines and amphetamine-like compounds, appetite suppressants, bromocriptine, buspirone, caffeine, carbidopa-levodopa (Sinemet), clonidine, dexamethasone, diuretics (in doses sufficient to deplete sodium), ethanol, isoproterenol, labetalol, methyldopa (Aldomet), MAO inhibitors, nicotine, nose drops, propafenone (Rythmol), reserpine, theophylline, tricyclic antidepressants, and vasodilators. The effects of drugs on catecholamine results may not be predictable.
Patient Preparation
To avoid false elevation in plasma catecholamines, patients should ideally sit and relax for about 15 minutes or lay supine for 30 minutes prior to sample collection . If this is not feasible, elevations in plasma catecholamines are possible due to the collection process itself.
"Upright" ranges show epinephrine up to 900 pg/mL, and norepinephrine up to 700 pg/mL.
Children, particularly those under 2 years of age, often show an elevated catecholamine response to stress.