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Test Code 180 Basic Metabolic Panel with Ionized Calcium

Important Note

This test is available at Mercy DV and MQMA sites only for their patients (STATS ONLY).

Additional Codes

MLAB: BMPICA

Powerchart: Basic metabolic Panel w Ionized Ca

Test Method

iSTAT

  • Bun: Ion Selective Electrode
  • Glucose: Oxidation; Amperometric
  • Creatinine: Conductivity
  • Sodium: Ion Selective Electrode
  • Potassium: Ion Selective Electrode
  • Chloride: Ion Selective Electrode
  • CO2: Rate of pH Change, CO2 Electrode
  • Ionized Calcium: Ion Selective Electrode

Specimen Requirement

0.5 mL venous whole blood is required.

Additional Specimen Collection Information

Collect blood in a lithium heparin, green-top from a fasting patient. (12 hour fast is recommended.) Serum tubes are NOT acceptable. Collection tubes must be filled to capacity. (Incomplete filling of anticoagulated tubes will cause higher heparin-to-blood ratios, which will decrease iCA resuts.) Samples must be taken to the lab immediately after collection. The test is typically performed immediately upon arrival in the lab. Samples must be run within 30 minutes of collection. Samples run for ionized calcium and TCO2 must be run within 10 minutes.

Performance

Testing is performed Monday through Sunday.

Routine orders: Typically completed within 1 hour.

Expedite orders: Typically completed within 1 hour.

STAT orders: Typically completed within 30 minutes.

Reference Values

BUN: 10 - 26 mg/dL

Glucose:  70 - 99 mg/dL

  • Critical values:
    • Low: < 50 mg/dL
    • High: > 450 mg/dL

Diagnostic thresholds for diabetes and lesser degrees of impaired glucose regulation

 

Test

Category

Fpg

2-h pg

Normal

<100 mg/dl (<5.6 mmol/L)

<140 mg/dl (<7.8 mmol/L)

Ifg

100-125 mg/dl (5.6-6.9 mmol/L)

_

Igt

_

140-199 mg/dl (7.8-11.0 mmol/L)

Diabetes*

≥ 126 mg/dl (≥ 7.0 mmol/L)

≥ 200 mg/dl (≥ 11.1 mmol/L)

When both tests are performed, ifg or igt should be diagnosed only if diabetes is not diagnosed by the other test. *a diagnosis of diabetes needs to be confirmed on a separate day.
Ref.: diabetes care, v.26, #11 – nov. 2003

 

Creatinine: 0.4 - 1.4 mg/dL

GFR (calculated): ≥ 60 mL/min/1.73m2

Sodium: 135 - 145 meq/L

  • Critical values:
    •  low:  < 120 meq/L
    •  high: > 160 meq/L

Potassium: 3.5 - 5.0 meq/L

  • Critical values:
    •  low: < 3.0 meq/L
    •  high:  > 6.0 meq/L

Chloride: 100 - 108 meq/L

CO2: 24 - 32 meq/L

  • Critical values:
    • Low: < 10.0 meq/L
    • High: > 40.0 meq/L

Anion gap: (calculated value:  7-16 meq/L)

Ionized calcium: 1.12-1.32 mmol/L

  • Critical values:
    • Low:  < 0.8 mmol/L
    • High: > 1.60 mmol/L

Hemodilution of the plasma by more than 20% associated with priming cardiopulmonary bypass pumps, plasma volume expansion or other fluid administration therapies using certain solutions may cause clinically significant error on ionized calcium results. These errors are associated with solutions that do not match the ionic characteristics of plasma. To avoid these errors when hemodiluting by more than 20%, use physiologically balanced multi-electrolyte solutions containing low-mobility anions (e.g. Gluconate) such as Normosol-R (Abbott Laboratories), Plasma-Lyte-A (Baxter Healthcare oCrporation), and Isolyte-S (B Braun Medical) rather than solutions such as normal saline or ringer’s lactate.

CPT Code Information

80047 Multi-test Laboratory Panels; Basic metabolic panel (Calcium, ionized)

Useful For

See individual constituents.

LOINC Code Information

70219-1 Basic Metabolic 2008 Panel With Ionized Calcium-Serum Or Plasma