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Beaumont Laboratory

Methemoglobin in Blood (MET HGB)

Met Hb, Hemiglobin, EPIC: LAB5349, SOFT: MHGB

Specimen Collection Criteria

Collect (preferred specimen): One Dark Green-top Lithium or Sodium Heparin tube. (Minimum Whole Blood: 0.5 mL)
Also acceptable:
One blood gas syringe (see Blood Gas Procedure below).*

Do NOT use Light Green Plasma Separator (PST) tubes.

*NOTE:
Blood Gas specimens should ONLY be collected at the Farmington Hills, Grosse Pointe, Royal Oak, or Troy Hospital Campuses. Specimens should NOT be collected at any other Beaumont Laboratory drawsite, Nursing Home, or Outreach office.

Blood Gas Procedure: 

  • A 1 mL or 3 mL plastic syringe containing dry heparin is usually used to collect the specimen.
  • At least 1-2 mL (0.3 mL for pediatric patients) of blood is needed to ensure proper assay.
  • Arterial specimens are collected by a physician, nurse, or respiratory therapist.
  • For specimens collected by syringe, any air bubbles present in the syringe must be immediately expelled, the needle removed, and the syringe tightly capped. The syringe is rolled between the palms of the hands to ensure mixing.
    • Note: The Radiometer safePico Self-fill™ syringe has a metal ball to ensure homogeneous mixing when the syringe is rolled between the palms of the hands.
  • Characterization of oxygen enrichment, at the time of arterial puncture, is required. This may be expressed as FiO2 fractional inspired oxygen concentration provided (e.g., 0.50), FiO2% (e.g., 50%), room air, or nasal cannula flow rate in liters per minute. The FiO2 must be noted on the requisition or entered as part of the electronic order for any arterial blood gas specimens. FiO2 is not required for venous blood gas orders.
  • The specimen must be properly labeled.
  • Place on wet ice for transport. Ice and Specimen must be kept separated.
    • Suggested: Place specimen in front pocket of the biohazard bag. Place ice in zip lock section of biohazard bag.
  • The specimen must be transported immediately to the STAT Laboratory (Royal Oak) or to the Chemistry Laboratory (Farmington Hills, Troy and Grosse Pointe).  

Physician Office/Drawsite Specimen Preparation

Lithium or Sodium Heparin tubes only.
DO NOT remove Vacutainer® stopper. Arrange for transportation to the Laboratory immediately. Maintain whole blood specimen refrigerated (2-8°C or 36-46°F) prior to transport. (Min: 0.5 mL)

Preparation for Courier Transport

Transport: Whole blood specimen, refrigerated (2-8°C or 36-46°F). (Min: 0.5 mL)

Rejection Criteria

  • Specimens collected in fluoride or oxalate tubes.
  • Clotted specimens.
  • Specimens not collected and processed as indicated. 

Storage

Specimen Stability for Testing:

Dark Green-top Heparin Tubes
Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 72 hours
Frozen (-20°C/-4°F or below): Unacceptable

Blood Gas Syringes

Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 1 hour
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Dark Green-top tubes: Refrigerated (2-8°C or 36-46°F) for 7 days.
Blood Gases: Specimens are disposed within 8 hours of testing.

Laboratory

Farmington Hills Chemistry Laboratory.
Grosse Pointe Chemistry Laboratory.
Royal Oak STAT Laboratory.
Troy Chemistry Laboratory.

Performed

Sunday - Saturday, 24 hours a day.
Routine results available within 4 hours.
STAT results available within 1 hour of receipt in the Laboratory.

Reference Range

0-2 % of total hemoglobin.

Test Methodology

Absorption Spectrophotometry.

Interpretation

Methemoglobin is an inactive, oxidized form of hemoglobin which does not contribute to the oxygen-carrying capacity of blood. Sulfhemoglobin at a concentration of approximately 10% decreases the Met Hgb reading by approximately 3.5%.
Methylene blue in a concentration of approximately 60mg/L blood strongly interferes with Met Hgb measurements, giving falsely low results (-17% for a blood sample with O2SAT=100% and -6% for a sample with O2SAT=0%).
Changes in pH directly influence Met Hgb results. The magnitude of effect depends on the Met Hgb level and the pH change.

Clinical Utility

This assay aids in the diagnosis of methemoglobinemia. Methemoglobinemia, with or without sulfhemogloblinemia, is most commonly encountered as a result of administration of such medications as phenacetin, phenazopyridine, sulfonamides, local anesthetics, dapsone, or following ingestion of nitrites or nitrates. Congenital methemoglobinemias are rare. In congenital methemoglobinemia, the methemoglobin concentration in blood is about 15-20% of total hemoglobin. These patients are mildly cyanotic and asymptomatic. In acquired (toxic) methemoglobinemia, the Met Hgb concentration may be much higher. Symptoms may be severe when methemoglobin is greater than 40% of hemoglobin. Very high methemoglobin concentrations may be fatal.

CPT Code

83055, 83857.

Test Codes

EPIC: LAB5349, SOFT: MHGB

Last Updated

12/29/2017

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This directory currently reflects information only for specimens collected and/or processed at the Farmington Hills, Grosse Pointe, Royal Oak, and Troy campuses.