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Test Code BHOB Beta-Hydroxybutyrate

Additional Codes

Cerner

NextGen

Beta-Hydroxybutyrate

Beta-Hydroxybutyrate

Alternate Name(s)

β-Hydroxybutyrate

BHOB

BHB

B-OH

Ketone Bodies

Serum Ketones

Beta-Hydroxy Butyric Acid

B-hydroxybutyrate

Methodology

Colorimetric (reflectance spectrophotometry).

Patient Preparation

None

Collection Instructions

Standard phlebotomy practices.

Specimen Requirements

Container

Specimen Type

Tube

Lithium Heparin Plasma

PST

 or  or 

Serum

 or 

SST

 or  or 

 

Stability

Storage

Temperature

Stability

Room Temperature

18-28°C

Not recommended

Refrigerated

 2-8°C

≤ 7 days

If separated from cells within 2 hours.

Frozen

≤-18 °C

Acceptable

Rejection Criteria

Gross Hemolysis

Result Reporting and Reference Values

  • Reference Range is 0.02 – 0.27 mmol/L
  • This test was developed and its performance characteristics determined by Fairbanks Memorial Hospital Laboratory. It has not been cleared or approved by the FDA. The laboratory is regulated under CLIA as qualified to perform high-complexity testing. This test is used for clinical purposes. It should not be regarded as investigational or for research.

Reflex Testing

None

Limitations

Lactic dehydrogenase and lactate have been shown to interfere with the assay. Oxalic acid has been incorporated into the reagent to eliminate this interference.

Useful For

Ketosis is a common feature in acutely ill patients and can result in a severe life- threatening metabolic acidosis in patients suffering from starvation, acute alcohol abuse, or diabetes mellitus. The degree of ketosis present can be rapidly determined by measuring the blood levels of ß-hydroxybutyrate, which accounts for approximately 75% of the ketone bodies present in serum (acetoacetate and acetone are also present). During periods of ketosis, ß-hydroxybutyrate levels increase more rapidly than the other ketoacids and have been shown to be a better index of ketoacidosis, including the detection of subclinical ketosis. In diabetics, the measurement of ß-hydroxybutyrate, in addition to the blood glucose level, is extremely important in the assessment of ketosis, the severity of diabetic coma, and is essential for the exclusion of hyperosmolar non-ketotic diabetic coma. Moreover, insulin requirements are often based on the extent of the existing hyperketonemia shown by the blood levels of ß-hydroxybutyrate.