Preanalytical increase of ammonia in blood specimens from healthy subjects

The course and magnitude of spontaneous increase in ammonia concentration in plasma on standing were investigated with EDTA-treated blood specimens from 36 healthy subjects with use of a sensitive and precise enzymic method. Over 90 min, the rates of increase were virtually constant at fixed temperature. The mean (and SE) rates at 0, 20, and 37 degrees C were 3.9 (0.23), 5.2 (0.23), and 25.2 (0.59) mumol/L per hour, respectively. At these temperatures, the plasma contributed at most 7%, 15%, and 10%, respectively, to the formation of ammonia in whole blood. In view of the medical needs and the measured rates of ammonia increase, an interval of 15 min between blood sampling and the start of centrifugation may be tolerated at a specimen temperature of 0 degree C. Rates of ammonia increase showed significant correlations with erythrocyte and platelet count as well as with the plasma activities of gamma-glutamyltransferase (EC 2.3.2.2) and alanine aminotransferase (EC 2.6.1.2).