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Ovid: Oxford Handbook of Acute Medicine

Editors: Ramrakha, Punit S.; Moore, Kevin P. Title: Oxford Handbook of Acute Medicine, 2nd Edition Copyright ©1997,2004 Oxford University Press (Copyright 1997, 2004 by Punit S Ramrakha and Kevin P Moore) > Back of Book > Resources > Appendices > Reference intervals Reference intervals Reference intervals: biochemistry (Always consult your local laboratory)

Substance Reference interval
Acid phosphatase (total) 1–5IU/litre
Acid phosphatase (prostatic) 0–1IU/litre
ACTH <80ng/litre
Alanine aminotransferase (ALT) 5–35IU/litre
Albumin 35–50g/litre
Aldosterone1 100–500pmol/litre
Alkaline phosphatase 30–300IU/litre (adults)
α-fetoprotein <10kU/litre
Amylase 0–180 Somogyi U/dl
Angiotensin II1 5–35pmol/litre
Antidiuretic hormone (ADH) 0.9–4.6pmol/litre
Aspartate transaminase (AST) 5–35IU/litre
Bicarbonate 24–30mmol/litre
Bilirubin 3–17µmol/litre (0.25–1.5mg/dl)
Calcitonin <0.1µg/litre
Calcium (ionized) 1.0–1.25mmol/litre
Calcium (total) 2.12–2.65mmol/litre
Chloride 95–105mmol/litre
2Cholesterol 3.9–5.5mmol/litre
LDL cholesterol 1.55–4.4mmol/litre
HDL cholesterol 0.9–1.93mmol/litre
Cortisol am midnight 450–700nmol/litre
Creatine kinase (CK) Men 25–195IU/litre
Women 25–170 IU/litre
Creatinine 70–≤130µmol/litre
C-reactive protein (CRP) 0–10
Ferritin 12–200µg/litre
Folate 5–6.3 nmol/litre (2.1–2.8µg/L)
γ-glutamyl transpeptidase (γ-GT) Men 11–51IU/litre
Women 7–33IU/litre
Glucose (fasting) 3.5–5.5mmol/litre
Glycosylated haemoglobin (HbA1C) 5–8%
Growth hormone <20mU/litre
Iron Men 14–31µmol/litre
Women 7–33IU/litre
Lactate dehydrogenase (LDH) 70–250IU/litre
Magnesium 0.75–1.05mmol/litre
Osmolality 278–305mosmol/kg
Parathyroid hormone (PTH) <0.8–8.5pmol/litre
Phosphate (inorganic) 0.8–1.45mmol/litre
Potassium (K+) 3.5–5.0mmol/litre
Prolactin Men <450 U/L; Women < 600U/L
Prostate specific antigen (PSA) 0–4ng/ml
Protein (total) 60–80g/litre
Red cell folate 0.36–1.44µmol/L (160–640µg/L)
Renin (erect/recumbent)1 2.8–4.5/1.1–2.7pmol/ml/h
Sodium (Na+) 135–145mmol/litre
Thyroid stimulating hormone (TSH) 0.3–3.8mU/litre
Thyroxine (T4) 70–140nmol/litre
Thyroxine (free) 10.0–26.0pmol/litre
Total iron binding capacity (TIBC) 54–75µmol/litre
Triglyceride (fasting) 0.55–1.90mmol/litre
Tri-iodothyronine (T3) 1.2–3.0nmol/litre
Urea 2.5–6.7mmol/litre
Urate Men 0.21–0.48mmol/litre
Women 0.15–0.39mmol/litre
Vitamin B12 0.13–0.68nmol/litre (>150ng/litre)
1The sample requires special handling: contact the lab.
2The level of cholesterol should be taken in clinical context.
Lowering levels above 5.5mmol/L reduces morbidity and mortality in primary and secondary prevention trials.

Reference intervals: urine

Substance Reference interval
Adrenaline 0.03–0.10µmol/24h
Cortisol (free) ≤280nmol/24h
Dopamine 0.65–2.70µmol/24h
Hydroxyindole acetic acid (HIAA) 16–73µmol/24h
Hydroxymethylmandelic acid (HMMA, VMA) 16–48µmol/24h
Metanephrines 0.03–0.69µmol/mmol creatinine
Noradrenaline 0.12–0.5µmol/24h
Osmolality 350–1000mosmol/kg
Phosphate (inorganic) 15–50mmol/24h
Potassium 14–120mmol/24h
Sodium 100–250mmol/24h

Reference intervals: cerebrospinal fluid see p952. Reference intervals: ascitic fluid see p657. Reference intervals: haematology

Measurement   Reference interval
WBC (white blood cells)   3.2–11.0 × 109/L
RBC (red blood cells) Men 4.5–6.5 × 1012/L
Women 3.9–5.6 × 1012/L
Haemoglobin (Hb) Men 13.5–18.0g/dl
Women 11.5–16.0g/dl
Haematocrit (HCT) or packed cell volume(PCV) Men 0.4–0.54 l/L
Women 0.37–0.47l/L
Mean cell volume (MCV) 82–98fl
Mean cell haemoglobin (MCH) 26.7–33.0pg
Mean cell haemoglobin concentration (MCHC) 31.4–35.0g/dl
Platelet count 120–400 × 109/L
Neutrophils % 40–75%
Abs. no. 1.9–7.7 × 109/L
Monocytes % 3.0–11.0%
Abs. no. 0.1–0.9 × 109/L
Eosinophils % 0.0–7.0 %
Abs. no. 0.0–0.4 × 109/L
Basophils % 0.0–1.0 %
Abs. no. 0.2–0.8 × 109/L
Lymphocytes % 20–45%
Abs. no. 1.3–3.5 × 109/L
Reticulocyte count1 0.8–2.0% (25–100×109/L)
Erythrocyte sedimentation rate depends on age (& ↑ in anaemia)
(ESR) Men ~ (age in years)-2
Women ~ (age in years + 10)–2
Prothrombin time (PT)-factors II, VII, and X 10–14 seconds
Activated partial thromboplastin time (APTT)-factors VIII, IX, XI, and XII 35–45 seconds
1Only use percentages if red cell count is normal; otherwise use absolute value.

Guidelines on oral anti-coagulation

International normalized ratio (INR) Clinical condition
2.0–3.0 Treatment of DVT, PE, TIAs; chronic AF.
3.0–4.5 Recurrent DVTs and PEs; arterial grafts and arterial disease (including MI); prosthetic cardiac valves.
Acid base nomogram in the interpretation of arterial blood gases (after Flenley DC(1971) Lancet I: 270–3)
Nomogram for body size

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