Chemistry Values
Table C-1
Blood Chemistry Values in Premature Infants during the First 7 Weeks of Life (Birth Weight 1500-1750 g)
Adapted from Thomas J, Reichelderfer T: Premature infants: analysis of serum during the first seven weeks, Clin Chem 14:272, 1968.
| Age 1 Week | Age 3 Weeks | Age 5 Weeks | Age 7 Weeks | |||||
|---|---|---|---|---|---|---|---|---|
| Constituent | Mean ± SD | Range | Mean ± SD | Range | Mean ± SD | Range | Mean ± SD | Range |
| Na (mEq/L) | 139.6 ± 3.2 | 133-146 | 136.3 ± 2.9 | 129-142 | 136.8 ± 2.5 | 133-148 | 137.2 ± 1.8 | 133-142 |
| K (mEq/L) | 5.6 ± 0.5 | 4.6-6.7 | 5.8 ± 0.6 | 4.5-7.1 | 5.5 ± 0.6 | 4.5-6.6 | 5.7 ± 0.5 | 4.6-7.1 |
| Cl (mEq/L) | 108.2 ± 3.7 | 100-117 | 108.3 ± 3.9 | 102-116 | 107.0 ± 3.5 | 100-115 | 107.0 ± 3.3 | 101-115 |
| CO 2 (mmol/L) | 20.3 ± 2.8 | 13.8-27.1 | 18.4 ± 3.5 | 12.4-26.2 | 20.4 ± 3.4 | 12.5-26.1 | 20.6 ± 3.1 | 13.7-26.9 |
| Ca (mg/dL) | 9.2 ± 1.1 | 6.1-11.6 | 9.6 ± 0.5 | 8.1-11.0 | 9.4 ± 0.5 | 8.6-10.5 | 9.5 ± 0.7 | 8.6-10.8 |
| P (mg/dL) | 7.6 ± 1.1 | 5.4-10.9 | 7.5 ± 0.7 | 6.2-8.7 | 7.0 ± 0.6 | 5.6-7.9 | 6.8 ± 0.8 | 4.2-8.2 |
| BUN (mg/dL) | 9.3 ± 5.2 | 3.1-25.5 | 13.3 ± 7.8 | 2.1-31.4 | 13.3 ± 7.1 | 2.0-26.5 | 13.4 ± 6.7 | 2.5-30.5 |
| Total protein (g/dL) | 5.49 ± 0.42 | 4.40-6.26 | 5.38 ± 0.48 | 4.28-6.70 | 4.98 ± 0.50 | 4.14-6.90 | 4.93 ± 0.61 | 4.02-5.86 |
| Albumin (g/dL) | 3.85 ± 0.30 | 3.28-4.50 | 3.92 ± 0.42 | 3.16-5.26 | 3.73 ± 0.34 | 3.20-4.34 | 3.89 ± 0.53 | 3.40-4.60 |
| Globulin (g/dL) | 1.58 ± 0.33 | 0.88-2.20 | 1.44 ± 0.63 | 0.62-2.90 | 1.17 ± 0.49 | 0.48-1.48 | 1.12± 0.33 | 0.5-2.60 |
| Hb (g/dL) | 17.8 ± 2.7 | 11.4-24.8 | 14.7 ± 2.1 | 9.0-19.4 | 11.5 ± 2.0 | 7.2-18.6 | 10.0 ± 1.3 | 7.5-13.9 |
BUN, Blood urea nitrogen; Hb, hemoglobin; SD, standard deviation.
Table C-2
Measured Variables in Cord and Whole Venous Blood in Healthy Term Neonates
From Dollberg S, Bauer R, Lubetzky R, et al: A reappraisal of neonatal blood chemistry reference ranges using the Nova M electrodes, Am J Perinatol 18:433, 2001.
| Cord Blood | 2- to 4-Hour Blood | |||
|---|---|---|---|---|
| Mean ± SD | Range | Mean ± SD | Range | |
| pH | 7.35 ± 0.05 | 7.19-7.42 | 7.36 ± 0.04 | 7.27-7.45 |
| P co 2 (mm Hg) | 40 ± 6 | 24.5-56.7 | 43 ± 7 | 30-65 |
| Hct (%) | 48 ± 5 | 37-60 | 57 ± 5 | 42-67 |
| Hb (g/L) | 1.65 ± 0.16 | 1.29-2.06 | 1.90 ± 0.22 | 0.88-2.3 |
| Na + (mmol/L) | 138 ± 3 | 129-144 | 137 ± 3 | 130-142 |
| K + (mmol/L) | 5.3 ± 1.3 | 3.4-9.9 | 5.2 ± 0.5 | 4.4-6.4 |
| Cl − (mmol/L) | 107 ± 4 | 100-121 | 111 ± 5 | 105-125 |
| iCa (mmol/L) | 1.15 ± 0.35 | 0.21-1.5 | 1.13 ± 0.08 | 0.9-1.3 |
| iMg (mmol/L) | 0.28 ± 0.06 | 0.09-0.39 | 0.30 ± 0.05 | 0.23-0.46 |
| Glucose (mmol/L) | 4.16 ± 1.05 | 0.16-6.66 | 3.50 ± 0.67 | 5.11-16.10 |
| Glucose (mg/dL) | 75 ± 19 | 2.9-120 | 63 ± 12 | 29-92 |
| Lactate (mmol/L) | 4.6 ± 1.9 | 1.1-9.6 | 3.9 ± 1.5 | 1.6-9.8 |
| BUN (mmol/L) | 2.14 ± 0.61 | 1.07-3.57 | 2.53 ± 0.71 | 1.43-4.28 |
| BUN (mg/dL) | 6.0 ± 1.7 | 3.0-10.0 | 7.1 ± 2.0 | 4-12 |
BUN, Blood urea nitrogen; Hb, hemoglobin; Hct, hematocrit; iCa, ionized calcium; iMg, ionized magnesium; SD, standard deviation.
Table C-3
Plasma Ammonia Levels in Preterm Infants of ≤32 Weeks’ Gestational Age
Modified from Usmanii SS, Cavaliere T, Casatelli J, et al: Plasma ammonia levels in very low birth weight preterm infants, J Pediatr 123:798, 1993.
| Ammonia Level ∗ | ||
|---|---|---|
| Age (days) | μmol/L | μg/dL |
| Birth | 71 ± 26 | 121 ± 45 † |
| 1 | 69 ± 22 | 117 ± 37 |
| 3 | 60 ± 19 | 103 ± 33 |
| 7 | 42 ± 14 | 72 ± 24 |
| 14 | 42 ± 18 | 72 ± 30 |
| 21 | 43 ± 16 | 73 ± 28 |
| 28 | 42 ± 15 | 72 ± 25 |
| Term infants at birth | 45 ± 9 | 77 ± 16 |
∗ Values represent mean ± 1 standard deviation unit.
† Plasma ammonia level declines significantly from birth to 7 days of age ( P <.01).
Table C-4
Liver Function Test Values
Adapted from Rosenthal P: Assessing liver function and hyperbilirubinemia in the newborn. National Academy of Clinical Biochemistry, Clin Chem 43:228, 1997.
| Test | Age | Value |
|---|---|---|
| Albumin (g/L) | 0-5 days (<2.5 kg) 0-5 days (>2.5 kg) 1-30 days 31-182 days 183-365 days | 20-36 26-36 26-43 28-46 28-48 |
| Prothrombin time (sec) | 1 day (30-36 wk of gestation) 5 days (30-36 wk of gestation) 30 days (30-36 wk of gestation) 90 days (30-36 wk of gestation) 180 days (30-36 wk of gestation) | 10.6-16.2 10.0-15.3 10.0-13.6 10.0-14.6 10.0-15.0 |
| 1 day 5 days 30 days 90 days 180 days | 11.6-14.4 10.9-13.9 10.6-13.1 10.8-13.1 11.5-13.1 | |
| Partial thromboplastin time (sec) | 1 day (30-36 wk of gestation) 5 days (30-36 wk of gestation) 30 days (30-36 wk of gestation) 90 days (30-36 wk of gestation) 180 days (30-36 wk of gestation) | 27.5-79.4 26.9-74.1 26.9-62.5 28.3-50.7 21.7-53.3 |
| 1 day 5 days 30 days 90 days 180 days | 37.1-48.7 34.0-51.2 33.0-47.8 30.6-43.6 31.8-39.2 | |
| Ammonia (μmol/L) | 1-90 days 3-11 mo | 42-144 34-133 |
| Aspartate aminotransferase (U/L) | 0-5 days 1-3 yr | 35-140 20-60 |
| Alanine aminotransferase (U/L) | 0-5 days 1-30 days 31-365 days | 6-50 1-25 3-35 |
| Alkaline phosphatase (U/L) | 0-5 days 1-30 days 31-365 days | 110-300 48-406 82-383 |
| γ-Glutamyltransferase (U/L) | 0-5 days 1-182 days 183-365 days | 34-263 12-132 1-39 |
For full-term infants unless otherwise noted.
Table C-5
Plasma-Serum Amino Acid Levels in Premature and Term Newborns (μmol/L)
From Behrman RE: Neonatal-perinatal medicine: diseases of the fetus and infant, ed 2, St Louis, 1977, Mosby, Appendix Table 20. Data from Dickinson JC, Rosenblum H, Hamilton PB: Ion exchange chromatography of the free amino acids in the plasma of the newborn infant, Pediatrics 36:2, 1965; and Dickinson JC, Rosenblum H, Hamilton PB: Ion exchange chromotography of the free amino acids in the plasma of infants under 2,500 gm at birth, Pediatrics 45:606, 1970.
| Amino Acid | Premature (First Day) | Newborn (Before First Feeding) | 16 Days to 4 Months |
|---|---|---|---|
| Taurine | 105-255 | 101-181 | |
| Hydroxyproline | 0-80 | 0 | |
| Aspartic acid | 0-20 | 4-12 | 17-21 |
| Threonine | 155-275 | 196-238 | 141-213 |
| Serine | 195-345 | 129-197 | 104-158 |
| Aspartate + Glutamate | 655-1155 | 623-895 | |
| Proline | 155-305 | 155-305 | 141-245 |
| Glutamic acid | 30-100 | 27-77 | |
| Glycine | 185-735 | 274-412 | 178-248 |
| Alanine | 325-425 | 274-384 | 239-345 |
| Valine | 80-180 | 97-175 | 123-199 |
| Cystine | 55-75 | 49-75 | 33-51 |
| Methionine | 30-40 | 21-37 | 15-21 |
| Isoleucine | 20-60 | 31-47 | 31-47 |
| Leucine | 45-95 | 55-89 | 56-98 |
| Tyrosine | 20-220 | 53-85 | 33-75 |
| Phenylalanine | 70-110 | 64-92 | 45-65 |
| Ornithine | 70-110 | 66-116 | 37-61 |
| Lysine | 130-250 | 154-246 | 117-163 |
| Histidine | 30-70 | 61-93 | 64-92 |
| Arginine | 30-70 | 37-71 | 53-71 |
| Tryptophan | 15-45 | 15-45 | |
| Citrulline | 8.5-23.7 | 10.8-21.1 | |
| Ethanolamine | 13.4-10.5 | 32.7-72 | |
| α-Amino- n -butyric acid | 0-29 | 8.7-20.4 |
Table C-6
Reference Serum Amino Acid Concentrations That Have Been Proposed as Standards for Neonates (μmol/L)
Modified from Hanning RM, Zlotkin SH: Amino acid and protein needs of the neonate: effects of excess and deficiency, Semin Perinatol 13:131, 1989. See also Moro G, Minoli I, Boehm G, et al: Postprandial plasma amino acids in preterm infants: influence of the protein source, Acta Paediatr 88:885, 1999.
| Amino Acid | Term Infant Fed Human Milk | Cord Blood |
|---|---|---|
| Isoleucine | 26-93 | 21-76 |
| Leucine | 53-169 | 47-120 |
| Lysine | 80-231 | 181-456 |
| Methionine | 22-50 | 8-42 |
| Phenylalanine | 22-71 | 24-87 |
| Threonine | 34-168 | 108-327 |
| Tryptophan | 18-101 | 19-98 |
| Valine | 88-222 | 98-276 |
| Alanine | 125-647 | 186-494 |
| Arginine | 42-148 | 28-162 |
| Aspartic acid | 5-51 | 18 ± 17 |
| Glutamic acid | 24-243 | 92 ± 57 |
| Glycine | 77-376 | 123-312 |
| Histidine | 34-119 | 42-136 |
| Proline | 82-319 | 72-278 |
| Serine | 0-326 | 57-174 |
| Taurine | 1-167 | 41-461 |
| Tyrosine | 38-119 | 34-83 |
| Cystine | 35-132 | 4-37 |
Table C-7
Reference Intervals for Urine Amino Acid Excretion in Untimed Samples (mmol per mol creatinine)
Modified from Venta R: Year-long validation study and reference values for urinary amino acids using a reverse-phase HPLC method, Clin Chem 47:575, 2001.
| Amino Acid | 0-1 Months (Mean) | 1-12 Months (Mean) |
|---|---|---|
| Aspartic acid | 9-57 (23) | 10-69 (26) |
| Glutamic acid | 31-96 (54) | 24-102 (50) |
| α-Aminoadipic acid | 7-96 (26) | 7-110 (29) |
| Hydroxyproline | 11-556 (100) | 5-238 (34) |
| Phosphoethanolamine | 13-167 (46) | 12-216 (51) |
| Serine | 48-509 (156) | 34-329 (51) |
| Asparagine | 15-223 (58) | 18-197 (59) |
| Glycine | 127-2042 (510) | 133-894 (345) |
| Glutamine | 37-600 (148) | 63-446 (168) |
| β-Alanine | 2-41 (8) | 2-38 (8) |
| Taurine ∗ | 12-1057 | 10-809 |
| Histidine | 23-676 (125) | 69-392 (164) |
| Citrulline | 1-18 (5) | 2-46 (9) |
| Threonine | 9-337 (56) | 12-145 (41) |
| Alanine | 34-358 (109) | 27-313 (93) |
| β-Aminoisobutyric acid | 0-520 (14) | 5-258 (36) |
| Carnosine | 3-184 (21) | 8-160 (36) |
| Arginine | 0-81 (10) | 0-40 (5) |
| Proline | 3-257 (29) | 2-90 (14) |
| 1-Methylhistidine | 0-78 (7) | 0-98 (7) |
| 3-Methylhistidine | 5-85 (20) | 10-95 (31) |
| Ethanolamine | 33-253 (91) | 57-221 (112) |
| Aminobutyric acid | 1-43 (5) | 1-58 (7) |
| Tyrosine | 5-74 (19) | 12-64 (28) |
| Valine | 3-34 (10) | 3-43 (11) |
| Methionine | 2-24 (7) | 2-18 (6) |
| Cystathionine | 1-26 (6) | 1-11 (4) |
| Cystine | 5-109 (24) | 2-42 (10) |
| Isoleucine | 2-37 (8) | 2-21 (6) |
| Leucine | 4-84 (17) | 4-72 (17) |
| Hydroxylysine | 3-49 (11) | 2-50 (9) |
| Phenylalanine | 2-49 (9) | 7-42 (17) |
| Tryptophan | 1-46 (8) | 3-37 (10) |
| Ornithine | 2-37 (8) | 2-19 (6) |
| Lysine | 6-464 (54) | 4-80 (18) |
| No. of subjects (male/female) | 20 (11/9) | 30 (16/14) |
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