Electrolytes, Plasma or Serum

LYTES - NOCO

Anion Gap (Calculation)
Carbon Dioxide
Chloride
Potassium
Sodium

1 ml serum from Green top (Lithium Heparin)

0.5 mL
Note: For neonate requirements see Neonate Minimum Blood Volumes

1 mL serum from Serum Gel or Red Top

Specimen Type	Temperature	Time
Plasma Li Hep	Refrigerated	48 hours
Serum SST	Refrigerated	48 hours
Red Top – Separated*	Refrigerated	48 hours

 
*Centrifuge and aliquot into a plastic vial.
 

Gross hemolysis

Monday through Sunday; Continuously

Same day

ANION GAP:

• SV:
  • 4-15
• MMC, NCMC, & BFCMC:
  • 4 - 16

CARBON DIOXIDE (CO₂):
0-31 days: 13-29 mmol/L
>31days: 21-32 mmol/L
Critical value (automatic call-back): <11 mmol/L or >40 mmol/L

CHLORIDE:

• SV:
  • 100-110 mmol/L
• MMC, NCMC & BFCMC: 
  • 95 - 108 mmol/L

POTASSIUM:

• SV:
  • 3.5-5.1 mmol/L
  • Critical value (automatic call-back):
    • 0-31 days: <3.0 or >7.0 mmol/L
    • 31 days-1 year: <3.0 or >6.1 mmol/L
    • 1-150 years: <3.0 or >6.0 mmol/L
• MMC, NCMC & BFCMC:
  • 0 - 8 days: 3.2 - 5.5 mmol/L
  • 8 - 31 days: 3.4 - 6.0 mmol/L
  • 1 - 7 months: 3.5 - 5.6 mmol/L
  • 7 months - 1 year: 3.5 - 6.1 mmol/L
  • ​1 - 150 years: 3.6 - 5.3 mmol/L
  • Critical value (automatic call-back):
    • 0-31 days: <3.0 or >7.0 mmol/L
    • 31 days-1 year: <3.0 or >6.1 mmol/L
    • 1-150 years: <3.0 or >6.0 mmol/L

SODIUM:

• SV:
  • 136-145 mmol/L
  • Critical values (automatic call-back):
    • 0-64 years: <121 or >159 mmol/L
    • 64-150 years: <126 or >154 mmol/L
• MMC, NCMC & BFCMC:
  • 134 - 147 mmol/L
  • Critical values (automatic call-back):
    • 0-64 years: <121 or >159 mmol/L
    • 64-150 years: <126 or >154 mmol/L

Sodium is the major extracellular cation and functions to maintain fluid distribution and osmotic pressure. Some causes of decreased levels of sodium include prolonged vomiting or diarrhea, diminished reabsorption in the kidney and excessive fluid retention. Common causes of increased sodium include excessive fluid loss, high salt intake and increased kidney reabsorption. Potassium is the major intracellular cation and is critical to neural and muscle cell activity. Some causes of decreased potassium levels include reduced intake of dietary potassium or excessive loss of potassium from the body due to diarrhea, prolonged vomiting or increased renal excretion. Increased potassium levels may be caused by dehydration or shock, severe burns, diabetic ketoacidosis, and retention of potassium by the kidney. Chloride is the major extracellular anion and serves to regulate the balance of extracellular fluid distribution. Similarly to the other ions, common causes of decreased chloride include reduced dietary intake, prolonged vomiting and reduced renal reabsorption as well as some forms of acidosis and alkalosis. Increased chloride values are found in dehydration, kidney failure, some forms of acidosis, high dietary or parenteral chloride intake, and salicylate poisoning.