Serum Ammonia Test: Ammonia is a nitrogen waste compound that is normally excreted in the urine. An elevated level of ammonia in the blood is an excessive accumulation of ammonia in the blood. An elevated level of ammonia in the blood occurs when the kidneys or liver are not working properly, allowing wastes to remain in the bloodstream. Ammonia, like many other waste products in the body, can be poisonous to cells, and a high level of ammonia in the blood can affect the entire body.
Also Known As: NH3m, Ammonia Level, Serum Ammonia, Plasma Ammonia, Ammonia
Purpose:
- To find the progression of liver disease and its response to treatment (Fulminant hepatitis or cirrhosis).
- To diagnose Reye’s syndrome.
- To follow the hepatic encephalopathy.
- In the case of a patient with hyperalimentation, taking high calorie I/V nutrition.
- The advice in the newborn when the infant has irritability, vomiting, lethargy, and develops seizures in the early days of birth.
Why Get Tested?
To detect an elevated level of ammonia in the blood that may be caused by severe liver disease, kidney failure, or certain rare genetic disorders; to help investigate the cause of changes in behavior and consciousness; to help diagnose hepatic encephalopathy or Reye syndrome
When To Get Tested?
When someone with or without liver disease or kidney failure experiences mental changes or lapses into a coma; when a newborn experiences frequent vomiting and increased lethargy or when a child has continuous vomiting and unusual sleepiness during recovery from a viral illness, such as the flu or chickenpox
Signs And Symptoms Of Hyperammonemia:
- Hyperammonemia exerts toxic effects on the central nervous system.
- Causes may be:
- Inherited. There is a deficiency of the urea cycle enzyme, common in infants.
- Acquired. The causes are liver diseases and renal failure.
- There is fatigue.
- There is a loss of appetite.
- There are nausea and vomiting.
- There is a loss of strength.
- Ultimately patient will have confusion.
- The patient may have pain abdomen or back.
- Precipitating causes of encephalopathy are:
- Dietary protein.
- Constipation.
- Drugs.
- Infection.
- Electrolytes and acid-base imbalance.
Common symptoms of elevated blood ammonia level:
Symptoms of elevated blood ammonia can occur frequently, even daily, or just occasionally. At times, any of these symptoms can be severe:
- Confusion
- Fatigue
- Loss of appetite
- Nausea with or without vomiting
- Pain in the back, sides or abdomen
- Weakness (loss of strength)
Sample Required:
- Whole blood is needed for the estimation of Ammonia.
- Plasma is prepared in EDTA or heparin other than ammonium heparinate.
- Fasting AM samples are preferred.
- There should be no smoking after 12 midnight.
- Avoid smoking in the vicinity of the test sample place.
- There should be no clinching of the hand.
- Ammonia is volatile gas so it should be transported in ice or test immediately.
- The specimen may be centrifuged at 4 °C.
- Perform the test within 20 minutes or freeze the plasma immediately.
- Urine 24 hours sample is preferred.
Sampling Precautions:
- Analyze the sample as soon as possible.
- Avoid hemolyzed sample, it increases the ammonia level because the RBCs contains more three times than plasma.
- Avoid clenching of the fist.
- Avoid exercise before taking the blood sample because it increases the level.
- Don’t smoke at least 8 hours prior to this test.
- One cigarette smoked one hour before the sample can raise the blood ammonia concentration to 100 to 200 µg/L.
- Smokers need a shower and new clothing.
- The technician should also be a non-smoker.
- Use of the tourniquet may increase the ammonia level.
- Avoid contamination of urine by bacteria or ammonia.
- Glassware should be clean and wash with a hypochlorite solution.
- EDTA and heparin are acceptable anticoagulants.
- The arterial blood sample is more reliable than venous but difficult to obtain, so venous blood is taken.
- Drugs that increase the level are:
- Acetazolamide.
- Alcohol.
- Barbiturates.
- Ammonium chloride.
- Narcotics.
- Parenteral nutrition.
- Diuretics.
- Drugs that decrease the level are:
- Broad-spectrum antibiotics (neomycin).
- Levodopa.
- Potassium salt.
- Lactobacillus.
Normal Values:
Source 1
- Adult = 10 to 80 µg /dL
- Child = 40 to 80 µg /dL
- Newborn = 90 to 150 µg /dL
Souce 2
- Normal range = 19 to 60 µg /dL
- Urine = 140 to 1500 µg /dL
Source 3
- 19 to 60 µg NH3 /dL (by Du Pont automated clinical analyzer)
- By Ektachem:
- 0 to 10 days = 170 to 341 µg NH3 /dL
- 10 days to 2 years = 68 to 136 µg NH3 /dL
- > 2 years = 19 to 60 µg NH3 /dL
Another source
- Adult = 15 to 56 µg /dL
- Birth to 10 days =109 to 182 µg /dL
- 10 days to 2 years = 95 to 157 µg /dL
- Children = 36 to 85 µg /dL
Increased Serum Ammonia:
- Hepatic failure
- Hepatic Encephalopathy
- Cirrhosis
- Reye’s Syndrome
- Portacaval shunt
- Medications
- Diuretics
- Polymixin B
- Methicillin
Decreased Serum Ammonia:
- Renal Failure
- Medications
- Neomycin
- Lactulose
- Tetracycline
FAQs:
What removes ammonia from the body?
The liver plays a crucial role in converting ammonia to urea, which is then excreted in urine by the kidneys. This process, known as the urea cycle, helps remove excess ammonia from the body.
Is ammonia a blood test?
Yes, ammonia tests are blood tests. They involve analyzing a blood sample to measure the concentration of ammonia, which provides valuable information about metabolic and liver health.
Is ammonia a liver test?
Yes, ammonia tests are used as a diagnostic tool to evaluate liver function. Elevated levels may indicate liver disease or dysfunction, particularly in cases of hepatic encephalopathy.
Is ammonia harmful?
Yes, high concentrations of ammonia are harmful. May cause respiratory and eye irritation. In the body, high levels can cause neurological damage and systemic toxicity.
Is ammonia acidic or basic?
Ammonia is a weak base. It can accept a proton (H+) to form NH4+ in a solution, making it capable of neutralizing acids. This property contributes to its role in regulating pH.
Does ammonia stay on ice?
Ammonia is usually stored or transported as a refrigerated liquid. Keeping it on ice during testing prevents its volatile nature from affecting the accuracy of ammonia level measurements.
What is the formula for ammonia?
The chemical formula of ammonia is NH3 and consists of one nitrogen atom bonded to three hydrogen atoms. It is a gas with a pungent odor at room temperature and pressure.
What color is ammonia ice?
Ammonia ice is colorless. It is commonly found as a clear liquid or white crystalline solid, and its appearance includes no inherent coloration.
What is the ammonia test called?
The ammonia test is often called a blood ammonia test or serum ammonia test. It measures the concentration of ammonia in the blood and provides information on liver function.
What is the normal level of ammonia?
Normal blood ammonia levels range between 15 and 45 micrograms per deciliter (mcg/dL). Deviations from this range may indicate liver dysfunction or other underlying problems.
What does ammonia do in the body?
Ammonia is a byproduct of protein metabolism. In excess, it becomes toxic and affects the central nervous system. The liver usually converts ammonia to urea for safe excretion.
Why is ammonia tested on ice?
Ammonia is tested on ice to prevent volatilization. Cold temperatures reduce evaporation, ensuring accurate measurements and reliable assessment of blood ammonia levels.
What is the ammonia test for?
Ammonia tests measure blood ammonia levels, evaluate liver function, and detect disorders such as hepatic encephalopathy, where the liver has difficulty processing ammonia.
Can ammonia testing be applied to the evaluation of ammonia-related odor problems in wastewater treatment?
Yes, ammonia testing is used to evaluate ammonia-related odor problems in wastewater treatment. High concentrations of ammonia can contribute to bad odors. Identifying the sources and levels of ammonia is crucial for odor control measures in wastewater treatment facilities.
How does ammonia affect the health and performance of animals in zoos and wildlife sanctuaries?
Ammonia can affect the health and performance of animals in zoos and wildlife sanctuaries by causing respiratory problems and stress. Proper management of ammonia levels in animal enclosures is essential to ensure the well-being and longevity of captive animals.
What is the role of ammonia in infrastructure corrosion in wastewater systems?
Ammonia plays a role in corrosion of infrastructure in wastewater systems by contributing to the formation of corrosive compounds. Monitoring and managing ammonia levels helps mitigate corrosion and extend the longevity of wastewater treatment infrastructure.
Can ammonia tests be applied in the evaluation of air quality in urban and industrial areas?
Yes, ammonia testing is relevant in assessing air quality in urban and industrial areas, especially where ammonia emissions are significant. Understanding the contribution of ammonia to air pollution is essential to assess and improve urban and industrial air quality.
How does ammonia affect the performance of wastewater treatment plants?
Ammonia can influence the performance of wastewater treatment plants by affecting nitrogen removal processes. High ammonia levels can disrupt nitrification and affect treatment efficiency. Effective monitoring and control of ammonia concentrations are essential for wastewater treatment plant operation.
What steps can be taken to reduce ammonia emissions from landfills?
Reducing ammonia emissions from landfills involves implementing proper waste management techniques and minimizing the decomposition of nitrogen-containing waste. These measures help mitigate air pollution and odor problems associated with landfill operations.
Can ammonia testing help in the management of ammonia emissions from transportation?
Yes, ammonia testing can help manage ammonia emissions from transportation sources, such as vehicles that use ammonia as a fuel or emissions control additive. Monitoring ammonia levels is vital to assess environmental impact and compliance with emissions standards.
How does ammonia affect algae growth in freshwater systems?
Ammonia can stimulate algal growth in freshwater systems, particularly harmful algal blooms. Excess ammonia can contribute to water quality problems, including decreased oxygen levels. Understanding this impact is vital to managing freshwater ecosystems and their health.
Can ammonia testing help prevent ammonia-related illnesses in industrial workers?
Ammonia testing is a critical component of preventing ammonia-related illnesses in industrial workers. Monitoring and maintaining safe levels of ammonia in workplaces, along with appropriate training and protective measures, are essential to safeguard the health and well-being of employees.
What role does ammonia play in the chemistry of coastal and marine environments?
Ammonia participates in various chemical processes in coastal and marine environments, such as nutrient cycling and the formation of nitrogen compounds. Understanding the roles of ammonia in these environments is vital to preserving the health of marine ecosystems and coastal areas.
Can ammonia testing contribute to the development of sustainable aquaponics systems?
Yes, ammonia testing is essential in developing sustainable aquaponics systems. Monitoring ammonia levels in aquaponics helps maintain a healthy balance between fish waste (ammonia) and plant nutrient requirements, ensuring the success of these integrated systems.
