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Table of ContentsABGp 3-4Electrolytesp 5-7Haematologyp 8-11Cardiacp 12Renalp 13Hepaticp 14-16Thyroidp 17Therapeutic Drug Valuesp 18-19

ABG Range (SI Units)Arterial Blood pHAdult/Child 7.35—745Newborn 7.32—7.49ph (Venous) 7.31—7.41Critical values (pH): <7.25 or >7.6Partial pressure of carbon dioxide (PaCO2)Adult 35—45 mmHgChild 26—41 mmHgPCO2(venous) 40—50 mmHgCritical values (PCO2) <20 or >60 mmHgBicarbonate (HCO3)Adult/Child 22—26 mEq/LNewborn 16—24 mEq/LCritical values (HCO3) <10 or >40 mEq/LPartial pressure of oxygen (PaO2)Adult 80—100 mmHgNewborn 60—70 mmHgPaO2(venous) 40—50 mmHgCritical value (PaO2) <40 mmHgABG Range (SI Units)Oxygen Saturation (SaO2)Adult >95%Newborn 40—90%Critical value (SaO2) <75%Oxygen Content (O2)Arterial 15—22 vol%Venous 11—16 vol%Base ExcessBase Excess Normal 0 ± 2 mEq/LCritical value (Base Excess) ±3 mEq/LAlveolar Arterial O2Difference <10 mmHgPo2,O2content may indicate:• Hyperventilation• Increased inspired O2Respiratory acidosis may indicate:• Respiratory failurePco2levels may indicate:• Chronic obstructive pulmonary disease• Head trauma• Over oxygenation in a patient with COPD• Over sedation• Pickwickian syndromeRespiratory alkalosis may indicate:• Acute and severe pulmonary disease• Anxiety neuroses• Carbon monoxide poisoning• Chronic heart failure• Cystic fibrosis• Pain• Pregnancy• Pulmonary emboli• ShockMetabolic acidosis may indicate:• Ketoacidosis• Lactic acidosis• Renal failure• Severe diarrheaIncreased pH levels (Alkalosis)Metabolic alkalosis may indicate:• Aldosteronism• Chronic vomiting• Chronic and high-volume gastric suction• Hypochloremia• Hypokalemia• Mercurial diureticsPco2levels may indicate:• Anxiety• Hypoxemia• Pain• Pregnancy• Pulmonary emboliPo2,O2content may indicate:• Adult respiratory distress syndrome• Anemias• Atelectasis• Atrial or ventricular cardiac septal defects• Bronchospasm• Emboli• Inadequate oxygen in inspired air (suffocation)Mucus plug• Pneumothorax• Pulmonary edema• Restrictive lung disease• Severe hypoventilation (e.g., neurologic somnolence, over sedationHCO3levels may indicate:• Aldosteronism• Chronic and high-volume gastric suction• Chronic vomiting• Chronic obstructive pulmonary disease• Use of mercurial diureticsHCO3levels may indicate:• Acute renal failure• Chronic and severe diarrhea• Chronic use of loop diuretics• Diabetic ketoacidosis• StarvationABG’sBack to Table of Contents

Respiratory AlkalosisRespiratory AcidosisMetabolic AcidosisMetabolic AlkalosisBack to Table of Contents

Sodium Na+ Range (SI Units) Range (Conventional)Adult135—145 mmol/L135—145 mEq/LChild136—145 mmol/L136—145 mEq/LInfant134—150 mmol/L134—150 mEq/LNewborn134—144 mmol/L134—144 mEq/LCritical values<120 or >160 mmol/L<120 or >160 mEq/LNa+ levels (Hypernatremia)may indicate:• Cushing's syndrome• Diabetes insipidus• Excessive dietary intake• Excessive IV sodium administration• Excessive sweating• Extensive thermal burns• Hyperaldosteronism• Osmotic diuresisNa+ levels (Hyponatremia) may indicate :• Ascites• Addison’s disease• Congestive Heart failure• Chronic renal insufficiency• Deficient dietary intake• Deficient sodium in IV fluids• Diarrhea• Diuretic administration• Excessive oral water intake• Excessive IV water intake• Intraluminal bowel loss (e.g., ileus or mechanical obstruction)• Osmotic dilution• Peripheral edema• Pleural effusion• Syndrome of inappropriate ADH (SIADH) secretion• Vomiting or nasogastric aspirationChloride CL- Range (SI Units) Range (Conventional)Adult95—105 mmol/L95—105 mEq/LChild90—110 mmol/L90—110 mEq/LNewborn96—106 mmol/L96—106 mEq/LPremature infant95—110 mmol/L95—110 mEq/LCritical values<80 or >115 mmol/L<80 or >115 mEq/LCL- levels (Hyperchloremia) may indicate:• Anemia• Cushing’s syndrome• Dehydration• Eclampsia• Excessive infusion of normal saline• Hyperparathyroidism• Hyperventilation• Kidney dysfunction• Metabolic acidosis• Multiple myelomas• Renal tubular acidosis• Respiratory alkalosisCL- levels (Hypochloremia) may indicate:• Addison’s disease• Aldosteronism• Burns• Chronic gastric suction• Chronic respiratory acidosis• Congestive heart failure• Diuretic therapy• Hypokalemia• Metabolic alkalosis• Overhydration• Respiratory alkalosis• Salt-losing nephritis• Syndrome of inappropriate antidiuretic hormone (SIADH)• VomitingPotassium K+ Range (SI Units) Range (Conventional)Adult3.5—5.0 mmol/L3.5—5.0 mEq/LChild3.4—4.7 mmol/L3.4—4.7 mEq/LInfant4.1—5.3 mmol/L4.1—5.3 mEq/LNewborn3.9—5.9 mmol/L3.9—5.9 mEq/LCritical values (Adult)<3.0 or >6.1 mmol/L<3.0 or >6.1 mEq/LCritical values (Newborn)<2.5 or >8.0 mmol/L<2.5 or >8.0 mEq/LK+ levels (Hyperkalemia) may indicate:• Acidosis• Acute or chronic renal failure• Aldosterone-inhibiting diuretics• Crush injuries to tissue• Dehydration• Excessive dietary intake• Excessive IV intake• Hemolysis• Hemolyzed blood transfusion• Hypoaldosteronism• InfectionElectrolytes 1/3K+ levels (Hypokalemia) may indicate:• Ascites, burns, Cushing’s syndrome• Cystic fibrosis• Deficient dietary intake, Deficient IV intake• Diuretics• Gastrointestinal disorders such as nausea and vomiting• Glucose administration• Hyperaldosteronism• Insulin administration• Licorice administration• Renal artery stenosis• Renal tubular acidosis• Surgery• TraumaBack to Table of Contents

Magnesium Mg Range (SI Units) Range (Conventional)Adult0.7—1.05 mmol/L1.3—2.1 mEq/LChild0.7—0.85 mmol/L1.4—1.7 mEq/LNewborn0.7—1.0 mmol/L1.4—2.0 mEq/LCritical values<0.25 or >1.5 mmol/L<0.5 or >3.0 mEq/LMg levels (Hypomagnesemia) may indicate:• Alcoholism• Chronic renal disease• Diabetic acidosis• Hypoparathyroidism• Malabsorption• MalnutritionMg levels (Hypermagnesemia) may indicate:• Addison’s disease• Hypothyroidism• Ingestion of magnesium-containing antacids or salt• Renal insufficiency• Uncontrolled diabetesTotal Calcium Range (SI Units) Range (Conventional)Adult 2.3—2.6 mmol/L9.0—10.5 mg/dL or4.5—5.2 mEq/LChild 2.2—2.7 mmol/L8.8—10.8 mg/dL or4.4—5.4 mEq/L10 days to 2 years 2.3—2.7 mmol/L9.0—10.6 mg/dL or4.5—5.3 mEq/LUmbilical 2.3—2.9 mmol/L9.0—11.5 mg/dL or4.5—5.7 mEq/L<10 days 1.9—2.6 mmol/L7.6—10.4 mg/dL or3.8—5.2 mEq/LCritical values <1.5 or >3.2 mmol/L<6.0 or 13 mg/dL or<3.0 or >6.5 mEq/LIonized CalciumAdult 1.1—1.4 mmol/L4.5—5.6 mg/dL or2.3—2.8 mEq/L<18 years 1.2—1.4 mmol/L4.8—5.5 mg/dL or2.4—2.7 mEq/LNewborn 1.1—1.4 mmol/L4.2—5.6 mg/dL or2.1—2.8 mEq/LCritical values <0.5 or >1.8 mmol/L<2.2 or >7.0 mg/dL or<1.1 or >1.4 mEq/LCa levels (Hypercalcemia) may indicate:• Acromegaly• Addison’s disease• Granulomatous infections such as tuberculosis and sarcoidosis• Hyperparathyroidism• Hyperthyroidism• Lymphoma• Metastatic tumor to the bone• Milk-alkali syndrome• Non-parathyroid PTH-producing tumor such as renal or lung carcinoma• Paget’s disease of bone• Prolonged immobilization• Vitamin D intoxicationCa levels levels (Hypocalcemia) may indicate:• Alkalosis• Fat embolism• Hyperphosphatemia secondary to renal failure• Hypoparathyroidism• Malabsorption• Osteomalacia• Pancreatitis• Renal failure• Rickets• Vitamin D deficiencyElectrolytes 2/3Back to Table of Contents

Serum Osmolality Range (SI Units) Range (Conventional)Adult285—295 mmol/kg285—295 mOsm/kg H2OChild275—290 mmol/kg275—290 mOsm/kg H2OCritical values<265 or >320 mmol/kg<265 or >320 mOsm/kg H20Serum Bicarbonate (HCO-3)Range (SI Units) Range (Conventional)Adult23—30 mmol/L23—30 mEq/LChild20—28 mmol/L20—28 mEq/LInfant20—28 mmol/L20—28 mEq/LNewborn13—22 mmol/L13—22 mEq/LCritical values<10 or >40 mmol/L<10 or >40 mEq/LPhosphorus (P) Range (SI Units) Range (Conventional)Adult0.97—1.45 mmol/L3.0—4.5 mg/dLChild1.45—2.1 mmol/L4.45—6.5 mg/dLNewborn1.4—3.0 mmol/L4.3—9.3 mg/dLCritical values<0.32 mmol/L<1.0 mg/dLP levels (Hyperphosphatemia) may indicate:• Acidosis• Acromegaly• Advanced myeloma or lymphoma• Bone metastasis• Hemolytic anemia• Hypocalcemia• Hypoparathyroidism• Increased dietary or IV intake of phosphorus• Liver disease• Renal failure• Rhabdomyolysis• SarcoidosisP levels (Hypophosphatemia) may indicate:• Alkalosis• Chronic alcoholism• Chronic antacid ingestion• Diabetic acidosis• Hypercalcemia• Hyperinsulinism• Hyperparathyroidism• Inadequate dietary ingestion of phosphorus• Malnutrition• Osteomalacia (adult)• Rickets (child)• Sepsis• Vitamin D deficiencyElectrolytes 3/3Back to Table of Contents

Haemoglobin Range (SI Units) Range (Conventional)Adult male 140—170 g/L 14—17 g/dLAdult female 120—150 g/L 12—15 g/dLPregnant >110 g/L >11 g/dLChild 95—150 g/L 9.5—15 g/dLNewborn 140—240 g/L 14—24 g/dLCritical values <70 or >200 g/L <7.0 or >20.0 g/dLHaematocrit Range (SI Units Range (Conventional)Adult male 0.42—0.52 42%—52%Adult female 0.35—047 35%—47%Pregnant >0.33 (>33%) >33%Child 0.30—0.44 30—44%Newborn 0.44—0.64 44%—64%Critical values <0.20 or >0.60 <20% or >60%Hb levels may indicate:• Chronic obstructive pulmonary disease• Congenital heart disease• Congestive heart disease• Dehydration• Hemoconcentration of the blood• High altitudes• Polycythemia vera• Severe burnsHct levels may indicate:• Burns• Chronic obstructive pulmonary disease• Congenital heart disease• Dehydration• Eclampsia• Erythrocytosis• Polycythemia Vera• Severe dehydrationHb levels may indicate:• Anemia• Cancer• Chronic hemorrhage• Hemolysis• Kidney disease• Lymphoma• Neoplasia• Nutritional deficiency• Sarcoidosis• Severe hemorrhage• Sickle cell anemia• Splenomegaly• Systemic lupus erythematosusHct levels may indicate:• Anemia• Bone marrow failure• Hemoglobinopathy• Hemolytic reaction• Hemorrhage• Hyperthyroidism• Leukemia• Liver cirrhosis• Malnutrition• Multiple myelomas• Normal pregnancy• Nutritional deficiency• Rheumatoid arthritisRBC Range (SI Units) Range (Conventional)Mean corpuscular volume (MCV)82—98 fL 82—98 mm3Mean corpuscular hemoglobin (MCH)0.40—0.53 fmol/cell26—34 pg/celMean corpuscular hemoglobin concentration (MCHC)320—360 g/L 32—36 g/dLReticulocyte Count 0.005—0.015 0.5%—1.5% of total RBCsSerum Iron Range (SI Units) Range (Conventional)Adult male 12.5—31.3 µmol/L 70—175 µg/dLAdult female 8.9—26.8 µmol/L 50—150 µg/dLChild 8.9—21.5 µmol/L 50—120 µg/dLNewborn 17.9—44.8 µmol/L 100—250 µg/dLTotal iron—binding capacity (TIBC)41.2—65.7 µmol/L 229—365 µg/dLTransferrin 2.15—3.75 g/L 215—375 mg/dLserum iron levels may indicate:• Hemochromatosis• Hemosiderosis• Hemolytic anemia• Hepatic necrosis• Hepatitis• Iron poisoning• Lead toxicity• Massive transfusionserum iron levels:• Chronic blood loss• Chronic gastrointestinal blood loss• Chronic hematuria• Chronic pathologic menstruation• Inadequate absorption of iron• Iron deficiency anemia• Lack of iron in the diet• Neoplasia• Pregnancy (late stages)HbIronHaematology 1/4Back to Table of Contents

ESRAgeESRMale<50 years:0—14 mm/hour50—85 years:0—19 mm/hour>85 years:0—29 mm/hourFemale<50 years:0—19 mm/hour50—85 years:0—29 mm/hour>85 years:0—41 mm/hourChild≥ 2 years0—10 mm/hourPlateletsRange (SI unit)Range (Conventional)Adult150—400 ✕109/L150,000—400,000/mm3Child150—400 ✕109/L150,000—400,000/mm3Infant200—475 ✕109/L200,000—475,000 mm3Premature infant100—300 ✕109/L100,000—300,000/mmNewborn150—300 ✕109/L150,000—300,000/mm3Critical values<20 or >1,000 ✕109/L<20,000 or >1 million/mm3Mean Platelet Volume (MPV)7.4—10.4 fL7.4—10.4 mm3FibrinogenRangeAdult200–400 mg/dLNewborn125–300 mg/dLCritical value<100 mg/dLESR levels may indicate:• Bacterial infection• Chronic renal failure• Hyperfibrinogenemia• Inflammatory disease• Macroglobulinemia• Malignant diseases• Severe anemias such as vitamin B12 deficiency or iron deficiencyPlatelet count (Thrombocytosis) may indicate:• Iron deficiency anemia• Malignant disorder• Polycythemia vera• Post splenectomy syndrome• Rheumatoid arthritisPlatelet count (Thrombocytopenia) may indicate:• Cancer• Chemotherapy• Disseminated intravascular coagulation• Hemolytic anemia• Hemorrhage• Hypersplenism• Immune thrombocytopenia• Infection• Inherited thrombocytopenia disorders such as Bernard-Soulier, Wiskott-Aldrich, or Zievesyndromes• Leukemia and other myelofibrosis disorders• Pernicious anemia• Systemic lupus erythematosus• Thrombotic thrombocytopeniaESR levels may indicate:• Hypofibrinogenemia• Polycythemia vera• Sickle cell anemia• SpherocytosisErythrocyte Sedimentation Rate:Assist in the diagnosis of conditions related to acute and chronic infection, inflammation, and tissue necrosis or infarction.Haematology 2/4Back to Table of Contents

D-Dimer<0.4 µg/mLProthrombin Time (PT) RangeNormal11—13 secondsFull anticoagulant therapy>1.5—2 times control valueCritical value>20 secondsINRRangeNormal0.8—1.2Therapeutic INR range for patients on warfarin2.0—3.0Therapeutic INR range for patients with mechanical heart valves3.0—4.0Critical value>5.0Activated Partial Thromboplastin Time (aPTT)Partial Thromboplastin time (PTT)aPTT PTTNormal30—40 seconds 60—70 secondsPatients receiving anticoagulant therapy1.5—2.5 times control value(60—80 seconds)1.5—2.5 seconds times control value(120—140 seconds)Critical valuesnone or >70 seconds none or >100 secondsHaematology 3/4APTT levels may indicate:• Early stages of disseminated intravascular coagulation• Extensive cancerAPTT levels may indicate:• Congenital clotting factor deficiencies• Disseminated intravascular coagulation• Hemophilia• Heparin administration• Hypofibrinogenemia von Willebrand’s disease• Leukemia• Liver cirrhosis• Vitamin K deficiencyDecreased prothrombin time may indicate:Blood clots quickly due to:• Supplements containing vitamin K• High intake of foods that contain vitamin K, such as liver, broccoli, kale, turnip greens and soybeansProthrombin time may indicate:• Bile duct obstruction• Coumarin ingestion• Disseminated intravascular coagulation• Hepatitis• Hereditary factor deficiency• Liver cirrhosis• Massive blood transfusion• Salicylate intoxication• Vitamin K deficiencyD-DimerHelps to diagnose the presence of thrombus in conditions such as deep vein thrombosis, pulmonary embolism or stroke.Used to diagnose disseminated intravascular coagulation (DIC).Back to Table of Contents

WBCRange (SI Units)Range (Conventional)Adult5.0—10 ✕109cells/L5000—10,000/mm3Child(≤2 years)6.2—17 ✕109cells/L6,200—17,000/mm3Newborn9.0—30 ✕109cells/L9,000—30,000/mm3Critical values2.0—40 ✕109cells/L<2,000 or > 40,000/mmWBCRange (SI Unit)Range (Conventional)Neutrophils2,500—8,000/mm355—70%Lymphocytes1,000—4,000/mm320—40%Monocytes100—700/mm32—8%Eosinophils50—500/mm31—4%Basophils25—100/mm30.5—1%Bands0—700/mm30—2%Haematology 4/4WBC count (Leukocytosis) may indicate:• Inflammation• Infection• Leukemic neoplasia• Stress• Tissue necrosis• TraumaWBC count (Leukopenia) may indicate:• Autoimmune disease• Bone marrow failure• Bone marrow infiltration (e.g., myelofibrosis)• Congenital marrow aplasia• Drug toxicity (e.g., chloramphenicol)• Nutritional deficiency• Severe infectionBack to Table of Contents

Creatine Kinase (CK) -TOTALRange (SI Units) Range (Conventional)Male 917—2833 nkat/L 55—170 units/LFemale 500—2250 nkat/L 30—135 units/LNewborn 1133—9667 nkat/L 68—580 units/LCK Isoenzymes Normal RangeCK-MM 100%CK-MB 0%CK-BB 0%levels of CPK-MM isoenzyme:• Crush injuries• Delirium tremens• Electroconvulsive therapy• Electromyography• Hypokalemia• Hypothyroidism• IM injections• Malignant hyperthermia• Muscular dystrophy• Myositis• Recent convulsions• Recent surgery• Rhabdomyolysis• Shock, Traumalevels of CPK-BB isoenzyme:• Adenocarcinoma (breast and lungs)• Disease involving the central nervous system• Pulmonary infarctionlevels of CPK-MB isoenzyme:• Acute myocardial infarction• Cardiac aneurysm surgery• Cardiac defibrillation• Cardiac ischemia• Myocarditis• Ventricular arrhythmiaslevels of total creatine phosphokinase (CPK):• Disease or injury affecting the brain, heart muscle, and skeletal muscleMyoglobin50-70ng/mlMyoglobin levels:• Malignant hyperthermia• Muscular dystrophy• Myocardial infarction• Myositis• Rhabdomyolysis• Skeletal muscle ischemia• Skeletal muscle traumaTroponins NormalTroponin <0.4 ng/mLCardiac troponin T* <0.1 ng/mLCardiac troponin I* <0.03 ng/mLTroponin levels may indicate:• Myocardial infarction• Myocardial injuryNatriuretic Peptides Normal RangeAtrial natriuretic peptide (ANP) 22—77 ng/LBrain natriuretic peptide (BNP) <100 ng/LC-type natriuretic peptide (CNP)Reference range provided with results should be reviewedNatriuretic peptides levels:• Congestive heart failure• Cor pulmonale• Heart transplant rejection• Myocardial infarction• Systemic hypertensionCardiacBack to Table of Contents

Creatinine (Serum) Range (SI Units) Range (Conventional)Creatinine (Serum)285—295 mmol/kg285—295 mOsm/kg H2OCritical values275—290 mmol/kg275—290 mOsm/kg H2OCreatinine (Urine)Male124—230 µmol/kg/day14—26 mg/kg/24 hoursFemale97—177 µmol/kg/day11—20 mg/kg/24 hoursCreatinine Clearance (CrCl)Male1.78—2.32 mL/sec107—139 mL/minFemale1.45—1.78 mL/sec87—107 mL/minNewborn0.67—1.08 mL/sec40—65 mL/minCreatinine levels may indicate:• Acromegaly• Acute tubular necrosis• Congestive heart failure• Dehydration• Diabetic nephropathy• Gigantism• Glomerulonephritis• Nephritis• Pyelonephritis• Rhabdomyolysis• Shock• Urinary tract obstructionCreatinine levels may indicate:• Debilitation• Myasthenia gravis• Muscular dystrophyBlood Urea Nitrogen (BUN) Range (SI Units) Range (Conventional)Adult3.57—7.14 mmol/L10—20 mg/dLChild1.79—6.43 mmol/L5—18 mg/dLInfant1.79—6.43 mmol/L5—18 mg/dLNewborn1.07—4.28 mmol/L3—12 mg/dLCritical values>35.7 mmol/L>100 mg/dLEstimated Glomerular Filtration Rate (eGFR)>60 mL/min/1.73 m2Blood urea nitrogen levels may indicate:• Alimentary tube feeding• Bladder outlet obstructions• Burns• Congestive heart failure• Dehydration• Excessive protein catabolism• Excessive protein ingestion• Gastrointestinal (GI) bleeding• Glomerulonephritis• Hypovolemia• Myocardial infarction• Nephrotoxic drugs• Pyelonephritis• Renal failure• Sepsis• Shock• Starvation• Ureteral obstructionBlood urea nitrogen levels may indicate:• Liver failure• Malnutrition or malabsorption• Nephrotic syndrome• Overhydration due to fluid overload or syndrome of inappropriate antidiuretic hormone (SIADH)• PregnancyRenalBack to Table of Contents

ALT- Liver Range (SI Units) Range (Conventional)Male 0.17—0.92 µkat/L 10—55 units/LFemale 0.12—0.50 µkat/L 7—30 units/LAlanine Aminotransferase (ALT) levels may indicate:• Cirrhosis• Cholestasis• Hepatitis• Hepatic ischemia• Hepatic necrosis• Hepatic tumor• Hepatotoxic drugs• Infectious mononucleosis• Myocardial infarction• Myositis• Obstructive jaundice• Pancreatitis• Severe burns• Shock• Trauma to striated muscleAlanine Aminotransferase (ALT) levels:• Is expected and is normalAspartate Aminotransferase (AST)Range (SI Units) Range (Conventional)Male 0.17—0.67 µkat/L 10—40 units/LFemale 0.15—0.42 µkat/L 9—25 units/LAspartate Aminotransferase (AST) levels may indicate:Heart diseases• Cardiac operations• Cardiac catheterization and angioplasty• Myocardial infarctionsLiver disease• Drug-induced liver injury• Hepatitis• Hepatic cirrhosis• Hepatic infiltrative process• Hepatic metastasis• Hepatic necrosis• Hepatic surgery• Infectious mononucleosis with hepatitisSkeletal muscle diseases• Heat stroke• Multiple traumas• Primary muscle diseases• Progressive muscular dystrophy• Recent convulsions• Recent noncardiac surgery• Severe, deep burns• Skeletal muscle traumaOther diseases• Acute hemolytic anemia• Acute pancreatitisAspartate Aminotransferase (AST) levels may indicate:• Acute renal disease• Beriberi• Chronic renal dialysis• Diabetic ketoacidosis• PregnancyHepatic 1/3Albumin: Range (SI Units) Range (Conventional)Adult 35—50 g/L 3.5—5.0 g/dLChild 40—59 g/L 4.0—5.9 g/dLInfant 44—54 g/L 4.4—5.4 g/dLNewborn 35—54 g/L 3.5—5.4 g/dLPremature infant 30—42 g/L 3.0—4.2 g/dLAlbumin levels (Hypoalbuminemia) may indicate:• Acute liver failure• Cirrhosis• Familial idiopathic dysproteinemia• Inflammatory disease• Increased capillary permeability• Malnutrition• Pregnancy• Protein-losing enteropathies• Protein-losing nephropathies• Severe burns• Severe malnutrition• Ulcerative colitisAlbumin levels (Hyperalbuminemia) may indicate:• Dehydration• Severe diarrhea• Severe vomitingBack to Table of Contents

Bilirubin Range(SI Units) Range (Conventional)Adult 5.1—17 μmol/L 0.3—1.0 mg/dLNewborn 17.1—205 µmol/L 1.0—12.0 mg/dLCritical values (Adult) >205 µmol/L >12 mg/dLCritical values (Newborn) >256 µmol/L >15 mg/dLDirect bilirubin (conjugated)1.7—5.1 μmol/L 0.1—0.3 mg/dLIndirect bilirubin (unconjugated)3.4—12.0 μmol/L 0.2—0.8 mg/dLConjugated (direct) bilirubin levels may indicate:• Cholestasis from drugs• Dubin-Johnson syndrome• Extensive liver metastasis• Extrahepatic duct obstruction (gallstone, inflammation, scarring, surgical trauma, or tumor)• Gallstones• Rotor’s syndromeUnconjugated (indirect) bilirubin levels may indicate:• Cirrhosis• Crigler-Najjar syndrome• Erythroblastosis fetalis• Gilbert’s syndrome• Hemolytic anemia• Hemolytic jaundice• Hepatitis• Large-volume blood transfusion• Neonatal hyperbilirubinemia• Resolution of a large hematoma• Pernicious anemia• Sepsis• Sickle cell anemia• Transfusion reactionAmylase Range (SI Units) Range (Conventional)Adult30–220 units/L or 500 nkat/L60—120 Somogyi units/dLNewborn3—32.5 units/L or 50—542 nkat/L6—65 Somogyi units/dLAmylase levels may indicate:• Acute pancreatitis• Acute cholecystitis• Diabetic ketoacidosis• Duodenal obstruction• Ectopic pregnancy• Necrotic bowel• Parotiditis• Penetrating peptic ulcer• Perforated peptic ulcer• Perforated bowel• Pulmonary infarctionAmylase levels may indicate: • Chronic pancreatitis• Cystic fibrosis• Liver disease• PreeclampsiaLipase0—160 units/LLipase levels may indicate:• Acute cholecystitis• Acute pancreatitis• Bowel obstruction or infarction• Cholangitis• Chronic relapsing pancreatitis• Extrahepatic duct obstruction• Pancreatic cancer• Pancreatic pseudocyst• Peptic ulcer disease• Renal failure• Salivary gland inflammation or tumorLipase levels may indicate:• Chronic conditions such as cystic fibrosisProtein Range (SI Units) Range (Conventional)Adult 54—83 g/L 5.4—8.3 g/dLChild 62—80 g/L 6.2—8.0 g/dLInfant 60—67 g/L 6.0—6.7 g/dLNewborn 46—74 g/L 4.6—7.4 g/dLPremature infant 42—76 g/L 4.2—7.6 g/dLProtein levels may indicate:• Amyloidosis• Dehydration• Hepatitis B• Hepatitis C• Human immunodeficiency virus• Multiple myelomaProtein levels may indicate:• Agammaglobulinemia• Bleeding• Celiac disease• Extensive burns• Inflammatory bowel disease• Kidney disorder• Liver disease• Severe malnutritionHepatic 2/3Back to Table of Contents

Glucose Range(SI Units) Range (Conventional)Glucose (Random, Casual) <11.1 mmol/L <200 mg/dLFasting Blood Sugar (FBS) <6.1 mmol/L 70—110 mg/dL2-hr Postprandial Glucose <7.7 mmol/L < 140 mg/dLGlucose levels (Hyperglycemia) may indicate:• Acromegaly• Acute pancreatitis• Acute stress response• Chronic renal failure• Corticosteroid therapy• Cushing’s syndrome• Diabetes mellitus• Diuretic therapy• Glucagonoma• PheochromocytomaGlucose levels (Hypoglycemia) may indicate:• Addison’s disease• Extensive liver disease• Hypopituitarism• Hypothyroidism• Insulinoma• Insulin overdose• StarvationPostprandial glucose levels (Postprandial hyperglycemia) may indicate:• Acromegaly• Acute stress response• Chronic renal failure• Corticosteroid therapy• Cushing’s syndrome• Diabetes mellitus• Diuretic therapy• Extensive liver disease• Gestational diabetes mellitus• Glucagonoma• Hyperthyroidism• Malnutrition• PheochromocytomaPostprandial glucose levels (Postprandial hypoglycemia) may indicate:• Addison’s disease• Hypopituitarism• Hypothyroidism• Insulinoma• Insulin overdose• Malabsorption or maldigestionLipid Profile Range (SI Units) Range (Conventional)CholesterolAdult <5.20 mmol/L <200 mg/dLChild 3.1—5.2 mmol/L 120—200 mg/dLInfant 1.8—4.5 mmol/L 70—175 mg/dLNewborn 1.4—3.5 mmol/L 53—135 mg/dLHigh-density lipoprotein (HDL)Male >0.75 mmol/L >45 mg/dLFemale >0.91 mmol/L >55 mg/dLLow-density lipoprotein (LDL)<3.4 mmol/L <130 mg/dLVery low-density lipoprotein (VLDL)0.18—0.83 mmol/L 7—32 mg/dLTriglycerides (TGs) 0.45—1.81 mmol/L 40—160 mg/dLCritical values (TGs) >4.5 mmol/L >400 mg/dLLDL and VLDL levels may indicate:• Alcohol consumption• Apoprotein CII deficiency• Chronic liver disease• Cushing’s syndrome• Familial hypercholesterolemia type IIa• Familial LDL lipoproteinemia• Gammopathies (e.g., multiple myeloma)• Glycogen storage disease (e.g., von Gierke’s disease)• Hepatoma• Hypothyroidism• Nephrotic syndromeHDL levels may indicate:• Extensive exercise• Familial HDL lipoproteinemiaLDL and VLDL Levels may indicate:• Familial hypolipoproteinemia• Hyperthyroidism• Hypoproteinemia (e.g., severe burns, malnutrition, or malabsorption)HDL levels may indicate:• Familial low HDL• Hepatocellular disease (e.g., cirrhosis or hepatitis)• Hypoproteinemia (e.g., malnutrition or nephrotic syndrome• Metabolic syndromeHepatic 3/3Back to Table of Contents

Thyroid Range (SI Units) Range (Conventional)Triiodothyronine, total (T3)1.2—3.5 nmol/L80—230 ng/dLThyroxine, total (T4)64—155 nmol/L5—12 µg/dLThyroxine, free (FT4)10—31 pmol/L0.8—2.4 ng/dLThyroid—stimulating hormone (thyrotropin)0.2—5.4 mIU/L0.2—5.4 µunits/mLTriiodothyronine levels may indicate:• Acute thyroiditis• Congenital hyperproteinemia• Factitious hyperthyroidism• Grave’s disease• Hepatitis• Pregnancy• Plummer’s disease• Struma ovarii• Toxic thyroid adenomaTriiodothyronine levels may indicate:• Cirrhosis• Cretinism• Cushing’s syndrome• Hypothalamic failure• Hypothyroidism• Iodine insufficiency• Liver disease• Myxedema• Pituitary insufficiency• Protein malnutrition and other protein-depleted states• Renal failure• Thyroid surgical ablationThyroxine (T₄) levels may indicate:• Acute thyroiditis• Congenital hyperproteinemia• Familial dysalbuminemic hyperthyroxinemia• Factitious hyperthyroidism• Grave’s disease• Hepatitis• Pregnancy• Plummer’s disease• Struma ovarii• Toxic thyroid adenomaThyroxine (T₄) levels mayindicate:• Cirrhosis• Cretinism• Cushing’s syndrome• Hypothalamic failure• Iodine insufficiency• Myxedema• Pituitary insufficiency• Protein-depleted states• Renal failure• Surgical ablation•Thyroxine, free (FT₄) levels may indicate:• Acute thyroiditis• Congenital hyperproteinemia• Familial dysalbuminemic hyperthyroxinemia• Factitious hyperthyroidism• Grave’s disease• Hepatitis• Pregnancy• Plummer’s disease• Struma ovarii• Toxic thyroid adenomaThyroxine Levels may indicate:• Cirrhosis• Cretinism• Cushing’s syndrome• Hypothalamic failure• Iodine insufficiency• Myxedema• Pituitary insufficiency• Protein-depleted states• Renal failure• Surgical ablationThyroid-stimulating hormone (thyrotropin)Abnormal findings:• Acute starvation• Hyperthyroidism• Hypothyroidism• Old age• Psychiatric primary depression• PregnancyThyroid Back to Table of Contents

Drug Name Drug Class Therapeutic Level (SI) Therapeutic Level (CV) Toxic Level (SI) Toxic Level (CV)Acetaminophen (Tylenol) Analgesic 66—132 µmol/L 10—20 µg/mL >170 µmol/L >25 µg/mLAmikacin Sulfate Aminoglycoside 26—43 µmol/L 15—25 µg/mL >430 µmol/L >250 µg/mLAminophylline (Norphyl) Bronchodilator 55.50—111 µmol/L 10—20 µg/mL >111 µmol/L >20 µg/mLAmitriptyline (Elavil) Antidepressants 433—541 nmol/L 120—150 ng/mL >1800 nmol/L >500 ng/mLCarbamazepine (Tegretol) Anticonvulsants 21—51 µmol/L 5—12 µg/mL >50 µmol/L >12 µg/mLCyclosporine (Gengraf) Calcineurin inhibitors 83—333 nmol/L 100—400 ng/mL >330 nmol/L >400 ng/mLDesipramine (Norpramin) Antidepressants 563—1126 nmol/L 150—300 ng/mL >1890 nmol/L >500 ng/mLDigitoxin (Digibind) Cardiac Glycoside 20—33 nmol/L 15—25 ng/mL >33 nmol/L >25 ng/mLDigoxin (Lanoxin) Antiarrhythmics 1—2.6 nmol/L 0.8—2 ng/mL >3 nmol/L >2.4 ng/mLDisopyramide (Norpace) Antiarrhythmics 6—15 µmol/L 2—5 µg/mL >15 µmol/L >5 µg/mLEthosuximide (Zarontin) Anticonvulsants 283—708 μmol/L 40—100 µg/mL >700 μmol/L >100 µg/mLGentamicin (Garamycin) Aminoglycosides 10—21 µmol/L 5—10 µg/mL >25 µmol/L >12 µg/mLImipramine (Tofranil) Antidepressants 535—1170 nmol/L 150—300 ng/mL >1780 nmol/L >500 ng/mLKanamycin (Kantrex) Aminoglycosides 41—52 µmol/L 20—25 µg/mL >70 µmol/L >35 µg/mLLidocaine (Xylocaine HCL) Anesthetic 6.4—21 µmol/L 1.5—5 µg/mL >20 µmol/L >5 µg/mLLithium (Eskalith) Antimanic 0.5—1.2 mmol/L 0.8—1.2 mEq/L >2 mmol/L >2 mEq/LTherapeutic Drug Values 1/2Therapeutic Drug Monitoring Lab ValuesBack to Table of Contents

Drug Name Drug Class Therapeutic Level (SI) Therapeutic Level (CV) Toxic Level (SI) Toxic Level (CV)Magnesium Sulfate Anticonvulsants 1.7—3 mmol/L 4—7 mg/dL >3 mmol/L >7 mg/dLMethotrexate (Trexall) Antimetabolites >0.01 µmol >0.01 µmol >10 µmol/24 hours >10 µmol/24 hoursNortriptyline (Aventyl HCl) Antidepressants 190—570 nmol/L 50—150 ng/mL >1900 nmol/L >500 ng/mLPhenobarbital (Luminal) Anticonvulsant 44—133 µmol/L 10—30 µg/mL >170 µmol/L >40 µg/mLPhenytoin (Dilantin) Antiarrhythmic 40—79 µmol/L 10—20 µg/mL >120 µmol/L >30 µg/mLPrimidone (Mysoline) Anticonvulsants 23—55 µmol/L 5—12 µg/mL >69 µmol/L >15 µg/mLProcainamide (Pronestyl) Antiarrhythmics 17—43 µmol/L 4—10 µg/mL >68 µmol/L >16 µg/mLPropranolol (Inderal) Antiarrhythmics 193—386 nmol/L 50—100 ng/mL >580 nmol/L >150 ng/mLQuinidine (Cardioquin) Antiarrhythmics 6—15 µmol/L 2—5 µg/mL >31 µmol/L >10 µg/mLSalicylate (Aspirin) Analgesic 0.72—18 mmol/L 100—2500 µg/mL >2 mmol/L >300 µg/mLSirolimus (Rapamune) Immunosuppressant 3—22 nmol/L 3—20 ng/mL >22 nmol/L >20 ng/mLTacrolimus (Astagraf XL) Calcineurin inhibitors 6—19 nmol/L 5—15 ng/mL >25 nmol/L >20 ng/mLTheophylline (Theo-24) Methylxanthines 56—111 µmol/L 10—20 µg/mL >111 µmol/L >20 µg/mLTobramycin Aminoglycosides 11—21 µmol/L 5—10 µg/mL >26 µmol/L >12 µg/mLValproic acid (Depakene) Anticonvulsants 350 —700 µmol/L 50—100 µg/mL >700 µmol/L >100 µg/mLVancomycin (Firvanq) Glycopeptide antibiotics 14—28 µmol/L 20—40 µg/mL >28 µmol/L >40 µg/mLTherapeutic Drug Monitoring Lab ValuesTherapeutic Drug Values 2/2Back to Table of Contents