Salicylate

CPT: 80299
Print Share

Test Details

Synonyms

  • Acetylsalicylic Acid, Blood
  • Aspirin, Blood

Methodology

Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Reference Interval

Therapeutic (anti-inflammatory): 30−250 μg/mL

Critical Value

Potentially toxic: >300 μg/mL

Additional Information

Optimal sampling time after dosage is two to six hours. Serum half-life is two to three hours on low-dose therapy, 15 to 30 hours on high-dose treatment. Optimal resampling time after change in dosage is six hours. In patients on chronic therapy, small dose changes may produce disproportionate changes in serum level. Use of antacids, which increase renal excretion, can lower serum levels. Steady-state concentrations for an individual patient are not adequately predicted from nomograms or standard dose schedules. In salicylate poisoning, the following symptoms may occur: initial alkalosis followed by acidosis in the blood, ketosis, and possible elevated plasma glucose. Glucose should be measured when levels >250 μg/mL are detected. Salicylate can be done on urine or gastric juice.

The Done nomogram is used to estimate blood level and prognosis following a single dose ingestion. The level measured four hours or more following ingestion is plotted. Specimens drawn earlier may not reflect the peak. The nomogram is not useful when accumulation over several ingestions exists. Urine pH and volume hourly are advocated with plasma pH, potassium and other electrolytes, prothrombin time, AST, ALT, serum bilirubin, and arterial blood gases for care of serious pediatric salicylate poisoning.1

Salicylate hepatitis, usually at blood levels of 200−250 μg/mL, occurs. Salicylates are believed to play a role in the hepatonecrosis of Reye syndrome in children. They are no longer recommended for use in children.

Specimen Requirements

Specimen

Serum or plasma

Volume

2 mL

Minimum Volume

0.6 mL

Container

Red-top tube or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant.

Collection

Transfer separated serum or plasma to a plastic transport tube. Optimal sampling time after dosage is two to six hours. Optimal resampling time after change in dosage is six hours.

Storage Instructions

Room temperature

Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Causes for Rejection

Gel tube; hemolysis; gross lipemia; icteric specimen

Clinical Information

Footnotes

1. Paulson JA. Poisonings from food, drugs, chemicals, pollutants, and venomous bites; mammalian bites. In: Behrman RE, Vaughn VC III, Nelson WE, eds. Nelson Textbook of Pediatrics. 13th ed. Philadelphia, Pa: WB Saunders Co;1987:1491,1516.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
007849 Salicylate, Serum 4024-6 007849 Salicylate, Serum ug/mL 4024-6
Reflex Table for Salicylate, Serum
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 007000 See below: 007000 See below: N/A

For Providers

Please login to order a test.

 

© 2017  Laboratory Corporation of America® Holdings and Lexi-Comp Inc. All Rights Reserved.

CPT Statement/Profile Statement

The LOINC® codes are copyright © 1994-2017, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Additional information regarding LOINC® codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf