Catecholamine Fractionation, Free, Plasma
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Catecholamine Fractionation, Free, Plasma | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
CATP
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Special Tube Required:
Purple top (EDTA- with sodium metabisulfite solution) tube
Collection Volume:
6ml
Storage:
Strict Frozen
Availability:
Sent to Reference laboratory
Methodology:
High- Pressure Liquid Chromatography (HPLC)
Special Instructions:
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).
Draw 6 mL of blood into one chilled EDTA Sodium Metabisulfite tube. Call specimen processing at 3305438418 to obtain the special EDTA collection tube.
Unless the purpose of the measurement is drug monitoring, discontinue any epinephrine, norepinephrine, or dopamine for at least 12 hours before specimen draw. Discontinue drugs that release epinephrine, norepinephrine, or dopamine or hinder their metabolism for at least 1 week before obtaining the specimen. If this is not possible for medical reasons contact the laboratory. Refrain from tobacco and drinking caffeinated beverages for at least 4 hrs. before specimen draw. Drawing from a catheter is required. Have patient rest for 30 min. in the supine position. Then withdraw and discard a minimum of 3mL of blood to remove saline out of the catheter.
Days Peformed: MonFri 9:00AM
Call laboratory to make sure they have proper tubes for collection and to verify collection requirements.
Lab/Phone:
330-543-8418
TAT:
2-5 days
Additional Info:
Reference range:
Norepinephrine:
Supine: 70-750 pg/mL
Standing: 200-1700 pg/mL
Epinephrine:
Supine: undetectable-110 pg/mL
Standing: undectable-140 pg/mL
Dopamine:
< 30 pg/mL ( no postural change)
CPT Code:
82384
Panel Includes:
Unconjugated norepinephrine,epinephrine, and dopamine
