Ammonia, Plasma

Alternate Name: Ammonia_P_LC

  | NH3

SAL Code:




Turn Around Time:

1-3 Days






Enzyme Immuonoassay (EIA)

Specimen Requirements:

Primary Tube:


Primary Substance:

Plasma (FRZN)

Alternate Sample Info:

Date and time specimen was drawn must be written on tube of blood and request form.



Stable Ambient:


Stable Fridge:

2 Hours in an ice bath

Stable Frozen:

3 days

Rejection Criteria:

Hemolysis which increases plasma ammonia; specimen not received frozen; anticoagulants such as citrate, oxalate, ammonium heparin, or sodium fluoride (may cause spuriously high results); lithium heparin may cause spuriously low results; serum specimen (ammonia values in serum are significantly but variably higher than their corresponding plasma values, as ammonia may be generated during clotting); lipemia

Clinical Info:

Ammonia is elevated in the following conditions: liver disease, urinary tract infection with distention and stasis, Reye syndrome, inborn errors of metabolism including deficiency of enzymes in the urea cycle, HHH syndrome (hyperammonemia-homocitrullinuria, hyperornithinemia), some normal neonates (usually returning to normal in 48 hours), total parenteral nutrition, ureterosigmoidostomy, and sodium valproate therapy. Ammonia determination is indicated in neonates with neurological deterioration, subjects with lethargy and/or emesis not explained, and in patients with possible encephalopathy.

Ammonia measurements are mainly of use in the diagnosis of urea cycle deficiencies (any neonate with unexplained nausea, vomiting, or neurological deterioration appearing after first feeding), and they play an important part in the detection of Reye syndrome.

Sample Collection:

Patient should be fasting 12 to 14 hours to avoid lipemia, which interferes with the test.

Tube must be filled completely and kept tightly stoppered at all times. Mix well. Specimen must be placed on ice immediately. Separate plasma from cells within 15 minutes of collection. Patient should not clench fist. Transfer specimen to a plastic transport tube before freezing. Avoid contamination of samples by ammonia. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested.

Test Limitations:

The correlation between blood ammonia levels and hepatic coma is poor. Ammonia determinations are not reliable predictors of impending hepatic coma.

Ammonia levels are not always high in all patients with urea cycle disorders. High protein diet may cause increased levels. Ammonia levels may also be elevated with gastrointestinal hemorrhage. If portal hypertension develops with cirrhosis, hepatic blood flow is altered, leading to elevated blood ammonia levels.

Test Handle Instructions:

Freeze immediately, maintain frozen.

Test Information: