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Hypoglycaemia - investigation in children

Alternate names:
Paediatric Hypoglycaemia screen
Laboratory:
Referred Test
Specimen types:
Blood and Urine
Container types:
Plain Tube with gel
Urine
Lithium heparin no gel
Heparinised Syringe
EDTA - Paediatric
Guthrie Card
Fluoride/oxalate tube (grey)
Plain Tube with gel
Collection Instructions:

 

At least  5 ml urine

pH, prot , gluc, ketones, blood, creatinine, GAGS, aminoacids, carnitines, org acids,

METU

FREEZE

(VCGS)

3x Serum (1mL Min Paediatric - red or adult white top)

 

1&2. Insulin, growth hormone, cortisol

 

3. LFT, U&E, anion gap 

REFER

 

 

  ECU, LFT

SPIN AND FREEZE(RCH)

 

(EH)

1mL blood ( Min)  Fluoride/Oxalate Tube (grey)

FFA,

hydroxybutyrate

FFA

OHBUT

SPIN AND FREEZE

(VCGS)

 1 arterial blood gas syringe

ABG, glucose, lactate (must be arterial for lactate)

ABGI

(EH)

1 x EDTA (Paediatric) On ice

ammonia

NH4

SPIN AND FREEZE(EH)

Guthrie card

Acyl carnitines

GUTH

(VCGS)

  

  • Sample should be taken when the patient is hypoglycaemic ( <2.5mmol/L )
Notes:

The above volumes are minimum requirements. Insufficient collection means not all tests will be performed.

 

 

 

Reference Interval:

Refer to result reports

Laboratory Use Only
Storage Instructions:

The following tests are covered by the samples listed above:

  • Acid Base Gas analysis
  • Glucose & Lactate
  • beta-hydroxy butyrate (Ketones)
  • Free fatty acids
  • Ammonia
  • Electolytes, Urea, Creatinine
  • Insulin
  • Cortisol, Growth Hormone
  • Urine Metabolic screen.
  • Acyl carnitines(Guthrie)

The above volumes are minimum requirements. Insufficient collection means not all tests will be performed.

Urine - freeze on arrival to lab and transport frozen to VCGS as per "Urine metabolic screen".  Code METU

 Guthrie card - Send to VCGS.  Code GUTH

 Serum: spin, separate and freeze first 2sample: Send to Complex Biochemistry RCH for Cortisol, Insulin and Growth Hormone. Minimum volume 300 ul serum (Note: this is different from usual procedures for these assays. )  Code : REFER

 Spin second sample and give to biochemistry for U&E,LFT. Code: EUL 

EDTA : Ammonia, spin & analyse immediately or freeze. Code: NH4

  Fluor OX: spin, separate and freeze. Send at least 1 mL to Metabolic lab VCGS for ketones and free fatty acids.  Code OHBUT and REFER.

Arterial blood gas syringe- Analyse as arterial blood 

If there is insufficient blood in particular samples, please contact requesting doctor and ask them to prioritise the tests for that sample.

 

 

External Laboratory:
Royal Childrens Hospital
 External Laboratory details...