1. Ammonia in plasma exists in equilibrium with the ammonium anion. Ammonia is also present in the atmosphere. When the sample is collected there is the possibility of the equilibrium being disturbed by the addition or loss of ammonia to the air space.

To mitigate against this affect we only analyse samples that arrive in the lab within 15 minutes of collection. You could reject grossly under-filled specimens but my experience is that such specimens are likely to be haemolysed and so would be rejected on that basis - ammonia is present in red cells at ~3 times the concentration of plasma.

2. The key step is to separate the plasma from the cells. Once that has happened ammonia still increases due to deamination reactions but at a slower rate. Low temperatures retard these reactions and so increase the stability.

We allow promptly separated plasma to be refrigerated if it can be analysed within 2 hours, otherwise it should be frozen.

Gavin

On 28 April 2016 at 14:00, Pullan Nicola (ROYAL UNITED HOSPITALS BATH NHS FOUNDATION TRUST) <[log in to unmask]> wrote:
Hello,

Can anyone help with the following?

1.      Our pack insert (Cobas) states that EDTA blood tubes should be full for ammonia analysis. We make no provision for this currently and don't bounce requests if the bottles are under-filled. Any opinion?

2.      If samples are separated from the cells and aliquoted into a sealed false bottomed tube for analysis at a later point e.g. if analyser out of action, any idea of stability?

Many thanks for any answers in advance.

Best wishes,

Nicola
Nicola Pullan
Principal Clinical Biochemist
Royal United Hospitals Bath NHS Foundation Trust
Combe Park, Bath, BA1 3NG
Dir Line: 01225 824711
Visit our website at: www.ruh.nhs.uk/pathology



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