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SI UNITS
5
The International System of Units (French: Systme International dUnits, 1. All reference intervals have been converted to SI units except in cases
SI) consists of seven dimensionally independent base units, which are listed in which the measurements are not quantitative.
in Table A5-1, along with the symbols to be used to denote these units. 2. Chemical names have not been changed; for example, urea is retained
Table A5-2 lists a number of derived units of the SI that are used in the instead of changing to carbamide.
clinical laboratory. There are two kinds of derived units: (1) coherent units, 3. Factors are those published by the American National Metric Council
which are derived directly from the base units without the use of conver- (Lundberg etal, 1986; Beeler, 1987; Young, 1987), based on the
sion factors, and (2) noncoherent units, which are constructed from the Metric Commission of Canada (1981) factors.
base units and contain a numerical factor to make the numbers more 4. Factors are calculated to the base unit for volume of 1L.
convenient to use. The prefixes to denote fractions or multiples of base 5. The order of magnitude of the factors is calculated to make the values
and derived SI units are given in Table A5-3. A complete description of in SI units convenient numbers, that is, with prefixes, a number not
the SI and its application in medicine may be found in the World Health greater than 1000 or smaller than 0.001.
Organization publication The SI for the Health Professions (World 6. The number in recommended SI units is equal to the number in
Health Organization, 1977). See Tietz (1995) for a comprehensive list of conventional units times the factor.
quantities and their internationally recommended SI units. 7. For compounds for which relative molecular masses are not definitely
The reference intervals used in this presentation should be considered known (e.g., proteins), reference intervals are converted to mass
typical values to illustrate principles of analysis; however, they are not amounts per liter.
intended to be used for interpretation of laboratory results for specific 8. For mixtures of indeterminate composition (e.g., phospholipids), ref-
patients which should be evaluated according to reference ranges estab- erence intervals are converted to mass amounts per liter or are based
lished by the laboratory performing those measurements. In making the on a given standard, for example, DHEA for 17-ketosteroids.
conversion to recommended SI units (Tables A5-4 through A5-13), the 9. Quantities of a relative nature that are usually expressed as per
following guidelines were followed: centages, for example, fractions of LD isoenzymes, are given as
fractions.
TABLE A5-1 10. Enzyme units are given as the international unit per liter (U/L).
SI Base Units Although the coherent SI unit for catalytic activity (including
enzymes), the katal, has been defined as the number of moles of sub-
Quantity Name Symbol strate converted per second under defined conditions, its adoption is
limited.
Length meter m 11. The pH scale is retained for measurement of hydrogen ion
Mass kilogram kg concentrations.
Time second s 12. It is recommended that the unit millimeters of mercury (mmHg) be
Electric current ampere A retained for pressure (Pco2, Po2) at the present time.
Thermodynamic temperature kelvin K
13. Percentages are expressed as fractions in the SI, where a fraction is a
dimensionless quantity given by the number of defined particles con-
Luminous intensity candela cd
stituting a specified component divided by the total number of defined
Amount of substance mole mol particles in the system.
TABLE A5-2
SI Derived Units TABLE A5-3
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TABLE A5-4
APPENDIX 5
Whole Blood, Serum, and Plasma Chemistry
TYPICAL REFERENCE INTERVALS
Acetoacetic acid
Qualitative Serum Negative Negative
Quantitative Serum 0.21mg/dL 97.95 20100mol/L
Acetone
Qualitative Serum Negative Negative
Quantitative Serum 0.32mg/dL 172.95 20340mol/L
Albumin
Qualitative Serum 3.24.5g/dL (salt fractionation) 10 3245g/L
3.25.6g/dL (electrophoresis) 3256g/L
3.85g/dL (eye binding) 3850g/L
Alcohol, ethyl Serum or whole blood Negativebut presented as mg/dL 0.2171 Negativebut presented as mmol/L
Aldolase Serum
Adults 38 Sibley-Lehninger U/dL at 37C 7.4 2259mU/L at 37C
Children Approximately 2 adult levels Approximately 2 adult levels
Newborn Approximately 4 adult levels Approximately 4 adult levels
-Amino acid nitrogen Serum 3.67mg/dL 0.7139 2.65mmol/L
-Aminolevulinic acid Serum 0.010.03mg/dL 76.26 0.82.3mol/L
Ammonia Plasma 20120g/dL (diffusion) 0.5872 1270mol/L
4080g/dL (enzymatic method) 2347mol/L
1248g/dL (resin method) 728mol/L
Amylase Serum 16120 Somogyi units/dL 1.85 30220U/L
Argininosuccinate lyase Serum 04U/dL 10 040U/L
Arsenic Whole blood <7g/dL 0.05055 <0.4mol/L
Ascorbic acid (vitamin C) Plasma 0.61.6mg/dL 56.78 3491mol/L
Whole blood 0.72mg/dL 40114mol/L
Barbiturates Serum, plasma, or whole Negative Negative
blood
Base excess Whole blood
Male 3.3 to +1.2mEq/L 1 3.3 to +1.2mmol/L
Female 2.4 to +2.3mEq/L 2.4 to +2.3mmol/L
Base, total Serum 145160mEq/L 1 145160mmol/L
Bicarbonate Plasma 2128mmol/L 1 2128mmol/L
Bile acids Serum 0.33mg/dL 10 330mg/L
Bilirubin
Direct (conjugated) Serum <0.3mg/dL 17.10 <5mol/L
Indirect (unconjugated) Serum 0.11mg/dL 217mol/L
Total Serum 0.11.2mg/dL 221mol/L
Newborns total Serum 112mg/dL 17205ol/L
Blood gases (see Chapter 14)
pH Whole blood 7.387.44 (arterial) 1 7.387.44
7.367.41 (venous) 7.367.41
PCO2 Whole blood 3540mmHg (arterial) 0.1333 4.75.3kPa
4045mmHg (venous) 5.36kPa
PO2 Whole blood 95100mmHg (arterial) 0.1333 12.713.3kPa
Bromide Serum <5mg/dL 0.125 <0.63mmol/L
Calcium
Ionized Serum 44.8mg/dL 0.2500 11.2mmol/L
22.4mEq/L 0.5000
3058% of total 0.01 0.301.58 of total
Total Serum 9.211.0mg/dL 0.2500 2.302.74mmol/L
4.65.5mEq/L 0.5000
Carbon dioxide (CO2 content) Whole blood (arterial) 1924mmol/L 1 1924mmol/L
Plasma or serum (arterial) 2128mmol/L 2128mmol/L
Carbon dioxide Whole blood (venous) 2226mmol/L 1 2226mmol/L
Plasma or serum (venous) 2430mmol/L 2430mmol/L
CO2 combining power Plasma or serum (venous) 2430mmol/L 1 2430mmol/L
CO2 partial pressure (PCO2) Whole blood (arterial) 3540mmHg 0.1333 4.75.3kPa
Whole blood (venous) 4045mmHg 5.36kPa
Carbonic acid (H2CO3) Whole blood (arterial) 1.051.45mmol/L 1 1.051.45mmol/L
Whole blood (venous) 1.151.50mmol/L 1.151.50mmol/L
Plasma (venous) 1.021.38mmol/L 1.021.38mmol/L
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TABLE A5-4
APPENDIX 5
Whole Blood, Serum, and Plasma Chemistrycontd
TYPICAL REFERENCE INTERVALS
Continued
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APPENDIX 5
TABLE A5-4
Whole Blood, Serum, and Plasma Chemistrycontd
TYPICAL REFERENCE INTERVALS
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TABLE A5-4
APPENDIX 5
Whole Blood, Serum, and Plasma Chemistrycontd
TYPICAL REFERENCE INTERVALS
Continued
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APPENDIX 5
TABLE A5-4
Whole Blood, Serum, and Plasma Chemistrycontd
TYPICAL REFERENCE INTERVALS
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TABLE A5-4
APPENDIX 5
Whole Blood, Serum, and Plasma Chemistrycontd
TYPICAL REFERENCE INTERVALS
Usually not measured in blood (preferred specimen is urine, hair, or nails except in acute cases, when gastric contents are used).
As cortisol.
1 International unit of insulin corresponds to 0.04167mg of the 4th International Standard (a mixture of 52% beef insulin and 48% pig insulin).
**As DHEA.
As triolein.
TABLE A5-5
Urine
TYPICAL REFERENCE INTERVALS
Continued
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APPENDIX 5
TABLE A5-5
Urinecontd
TYPICAL REFERENCE INTERVALS
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TABLE A5-5
APPENDIX 5
Urinecontd
TYPICAL REFERENCE INTERVALS
11-Ketoetiocholanolone 24hr
Male 0.21mg/day 3.274 0.73.3mol/day
Female 0.20.8mg/day 0.72.6mol/day
Lactose 24hr 1440mg/day 2.291 41117mol/day
Lead 24hr <100g/day 0.004826 <0.48mol/day
Magnesium 24hr 68.5mEq/day 0.5000 34.3mmol/day
Melanin, qualitative Random Negative Negative
Mucin 24hr 100150mg/day 1 100150mg/day
Muramidase (lysozyme) 24hr 1.336mg/day 1 1.336mg/day
Myoglobin 24hr 1440mg/day 2.291 41117mol/day
Qualitative Random Negative Negative
Quantitative 24hr <4mg/L 1 <4mg/L
Osmolality Random 500800mOsm/kg water 1 500800mmol/kg
Pentoses 24hr 25mg/kg/day 1 25mg/kg/day
pH Random 4.68 1 4.68
Phenolsulfonphthalein (PSP) Urine timed after 6mg Fraction dye excreted:
PSP IV
15min 20%50% dye excreted 0.01 0.200.50
30min 16%24% dye excreted 0.160.24
60min 9%17% dye excreted 0.090.17
120min 3%10% dye excreted 0.030.10
Phenylpyruvic acid, qualitative Random Negative Negative
Phosphorus Random 0.91.3g/day 32.29 2942mmol/day
Porphobilinogen
Qualitative Random Negative Negative
Quantitative 24hr <1mg/day 4.420 <4.4mol/day
Potassium 24hr 4080mEq/day 1 4080mmol/day
Pregnancy tests Concentrated morning Positive in normal pregnancies or with Positive in normal pregnancies or
specimen tumors producing chorionic with tumors producing chorionic
gonadotropin gonadotropin
Pregnanediol 24hr
Male <1.5mg/day 3.120 <4.7mol/day
Female 18mg/day 3.120 325mol/day
Peak 1 week after ovulation 1 week after ovulation
Pregnancy <50mg/day 3.120 <156mol/day
Children Negative Negative
Pregnanetriol 24hr
Male 0.42.4mg/day 2.972 1.27mol/day
Female 0.52mg/day 1.55.9mol/day
Children Up to 1mg/day Up to 3mol/day
Protein, qualitative Random Negative Negative
24hr 40150mg/day 1 40150mg/day
Reducing substances, total 24hr 0.51.5mg/day 1 0.51.5mg/day
Sodium 24hr 75200mEq/day 1 75200mmol/day
Solids, total 24hr 5570g/day 1 5570g/day
Decreases with age to 30g/day Decreases with age to 30g/day
Specific gravity Random Relative density (U 20C/water
20C):
1.0161.022 (normal fluid intake) 1 1.0161.022 (normal fluid intake)
1.0011.035 (range) 1.0011.035 (range)
Sugars (excluding glucose) Random Negative Negative
Titratable acidity 24hr 2050mEq/day 1 2050mmol/day
Urea nitrogen 24hr 617g/day 35.70 214607mmol/day
Uric acid 24hr 250750mg/day 0.005948 1.54.5mmol/day
Urobilinogen 2hr 0.31 Ehrlich units 1 0.31U
24hr 0.052.5mg/day or 1.693 0.14.2mol/day
0.54 Ehrlich units/day 1 0.54U/day
Uropepsin Random 1545 units/hr (Anson) 7.37 111332U/hr
24hr 15005000 units/day (Anson) 1137kU/hr
Continued
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APPENDIX 5
TABLE A5-5
Urinecontd
TYPICAL REFERENCE INTERVALS
Uroporphyrins
Qualitative Random Negative Negative
Quantitative 24hr 1030g/day 1.204 1236nmol/day
Vanillylmandelic acid (VMA) 24hr 1.57.5mg/day 5.046 7.637.9mol/day
Volume, total 24hr 6001600mL/day 0.001 0.61.6L/day
Zinc 24hr 0.151.2mg/day 15.30 2.318.4mol/day
*As norepinephrine.
As normetanephrine.
Based on cystine.
Based on estriol.
TABLE A5-6
Synovial Fluid
TYPICAL REFERENCE INTERVALS
TABLE A5-7
Seminal Fluid
TYPICAL REFERENCE INTERVALS
TABLE A5-8
Gastric Fluid
TYPICAL REFERENCE INTERVALS
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TABLE A5-9
APPENDIX 5
Hematology
TYPICAL REFERENCE INTERVALS
Continued
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APPENDIX 5
TABLE A5-9
Hematologycontd
TYPICAL REFERENCE INTERVALS
% (w/v) NaCl Fresh 24hr at 37C % NaCl 171 NaCl mmol/L Fresh 24hr at 37C
% Lysis 0.01
0.2 95100 34.2 0.951
0.3 97100 85100 51.3 0.971.00 0.851
0.35 9099 75100 59.8 0.900.99 0.751
0.4 5095 65100 68.4 0.500.95 0.651
0.45 545 5595 77.0 0.050.45 0.550.95
0.5 0.6 4085 85.5 00.06 0.400.85
0.55 1570 94.1 0 0.150.70
0.6 040 102.6 00.40
0.65 010 111.2 00.10
0.7 05 119.7 00.05
0.75 95100 128.3 0
Platelet count 150,000450,000/L 106 150450109/L
Reticulocyte count 0.5%1.5% 0.01 Number fraction: 0.0050.015
25,00075,000 cells/L 106 2575109/L
Sedimentation rate (ESR)
(Westergren)
Men younger than 50yr <15mm/hr
Men 5085yr <20mm/hr
Men older than 85yr <30mm/hr
Women younger than 50yr <20mm/hr
Women 5085yr <30mm/hr
Women older than 85yr <42mm/hr
Viscosity 1.41.8 times water 1 1.41.8 times water
Zeta sedimentation ratio 41%54% 0.01 Fraction: 0.410.54
TABLE A5-10
Amniotic Fluid
TYPICAL REFERENCE INTERVALS
Appearance
Early gestation Clear Clear
Term Clear or slightly opalescent Clear or slightly opalescent
Albumin
Early gestation 0.39g/dL 10 3.9g/L
Term 0.19g/dL 1.9g/L
Bilirubin
Early gestation <0.075mg/dL 17.10 <1.3mol/L
Term <0.025mg/dL <0.41mol/L
Chloride
Early gestation Approximately equal to serum chloride Approximately equal to serum chloride
Term Generally 13mEq/L lower than serum chloride 1 Generally 13mmol/L lower than serum chloride
Creatinine
Early gestation 0.81.1mg/dL 88.40 7197mol/L
Term 1.84mg/dL (generally >2mg/dL) 159354mol/L (generally >177mol/L)
Estriol
Early gestation <10g/dL 3.468 <347nmol/L
Term <60g/dL >2081nmol/L
Lecithin: sphingomyelin
Early (immature) <1:1 1 <1:1
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TABLE A5-10
APPENDIX 5
Amniotic Fluidcontd
TYPICAL REFERENCE INTERVALS
TABLE A5-11
Cerebrospinal Fluid
TYPICAL REFERENCE INTERVALS
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APPENDIX 5
TABLE A5-12
Miscellaneous
TYPICAL REFERENCE INTERVALS
TABLE A5-13
Selected Pediatric Reference Values
Parameter Value
S-Acid phosphatase
Newborn 7.419.4U/L
213yr 6.415.2U/L
S-Aldolase
Newborn to 4 adult value
Child to 2 adult value
S-Alkaline phosphatase
Newborn 40300U/L
Child 60270U/L
S--fetoprotein
Newborn Up to 150mg/L or higher
12yr Up to 87mg/L
S-Amylase
Newborn Little, if any, amylase activity
1yr Adult values
S-Aspartate aminotransferase
Newborn 1674U/L
13yr 630U/L
S-Bilirubin, newborn Preterm Full-term
24hr 17103mol/L (1060mg/L) 34103mol/L (2060mg/L)
48hr 17103mol/L (1060mg/L) 103120mol/L (6070mg/L)
35 day 171257mol/L (100150mg/L) 68205mol/L (40120mg/L)
S-Calcium
Preterm, first week 1.502.50mmol/L (60100mg/L)
Full-term, first week 1.753mmol/L (70120mg/L)
12yr 2.503mmol/L (100120mg/L)
216yr 2.252.87mmol/L (90115mg/L)
U-Catecholamines Norepinephrine: Epinephrine:
1yr 3090nmol/day (5.415.9g/day) 123nmol/day (0.14.3g/day)
15yr 50180nmol/day (8.130.8g/day) 450nmol/day (0.89.1g/day)
615yr 110420nmol/day (1971.1g/day) 7339nmol/day (1.310.5g/day)
>15yr 200510nmol/day (34.487g/day) 1972nmol/day (3.513.2g/day)
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TABLE A5-13
APPENDIX 5
Selected Pediatric Reference Valuescontd
Parameter Value
Continued
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APPENDIX 5
TABLE A5-13
Selected Pediatric Reference Valuescontd
Parameter Value
S-Immunoglobulin M
05wk <200mg/L
6mo 300600mg/L
1yr 3001600mg/L
5yr 2002200mg/L
10yr 3001700mg/L
Inulin clearance
<1mo 2988mL/min per 1.73m2 of body surface
16mo 40112mL/min per 1.73m2 of body surface
612mo 62121mL/min per 1.73m2 of body surface
>1yr 78164mL/min per 1.73m2 of body surface
U-17-Ketosteroids*
03 day 00.2mol/day (00.5mg/day)
13yr <7.0mol/day (<2.0mg/day)
36yr 210mol/day (0.53.0mg/day)
69yr 314mol/day (0.84.0mg/day)
Male Female
1012yr 221mol/day (0.76.0mg/day) 217mol/day (0.75.0mg/day)
Adolescent 1052mol/day (315mg/day) 1042mol/day (312mg/day)
S-Lactate dehydrogenase
13 day Up to 2 adult values
S-Phosphorus (inorganic)
Preterm newborn 1.812.58mmol/L (56.080.0mg/L)
610 day 1.973.78mmol/L (61117mg/L)
4mo 1.552.62mmol/L (4881mg/L)
1yr 1.261.94mmol/L (3960mg/L)
216yr 0.841.61mmol/L (2650mg/L)
S-Potassium
Preterm newborn 4.57.2mmol/L
Full-term newborn 5.07.7mmol/L
2 day2wk 4.06.4mmol/L
2wk3mo 4.06.2mmol/L
3mo1yr 3.75.6mmol/L
116yr 3.65.2mmol/L
S-Testosterone Male Female
02yr 0.141.28nmol/L (00.4ng/mL) 0.240.62nmol/L (0.10.2ng/mL)
24yr 0.175.55nmol/L (01.6ng/mL) 0.240.69nmol/L (0.10.2ng/mL)
46yr 0.281.39nmol/L (0.10.4ng/mL) 0.350.69nmol/L (0.10.2ng/mL)
68yr 0.219.72nmol/L (0.12.8ng/mL) 0.521.04nmol/L (0.10.3ng/mL)
810yr 0.311.74nmol/L (0.10.5ng/mL) 0.691.39nmol/L (0.20.4ng/mL)
1012yr 0.2910.06nmol/L (0.12.9ng/mL) 0.691.74nmol/L (0.20.5ng/mL)
1214yr 0.1726.37nmol/L (07.6ng/mL) 1.042.43nmol/L (0.30.7ng/mL)
1416yr 3.1219.43nmol/L (0.95.6ng/mL) 1.213.30nmol/L (0.31.0ng/mL)
1618yr 9.0225.33nmol/L (2.67.3ng/mL) 1.393.30nmol/L (0.41.0ng/mL)
1820yr 13.8824.98nmol/L (4.07.2ng/mL) 1.393.30nmol/L (0.41.0ng/mL)
2025yr 11.8038.86nmol/L (3.411.2ng/mL) 1.393.30nmol/L (0.41.0ng/mL)
S-Thyroxine
13 day 142296nmol/L (11.023.0g/dL)
1wk1mo 116232nmol/L (9.018.0g/dL)
14mo 97212nmol/L (7.516.5g/dL)
412mo 71187nmol/L (5.514.5g/dL)
16yr 71174nmol/L (5.513.5g/dL)
610yr 64161nmol/L (5.012.5g/dL)
Information based on Meites S, editor: Pediatric clinical chemistry, Washington, DC, 1977, American Association for Clinical Chemistry.
P, Plasma; S, serum; U, urine.
*As DHEA.
REFERENCES
Beeler MF: SI units and the AJCP, Am J Clin Pathol 87: Metric Commission of Canada: The SI manual in health- World Health Organization: The SI for the health profes-
140, 1987. care, Ottawa, 1981, Sector 9.10 Health and Welfare, sions, Geneva, 1977, WHO.
Lundberg GD, Iverson C, Radulescu G: Now read Metric Commission of Canada. Young DS: Implementation of SI units for clinical labo-
this: the SI units are here, JAMA 255:2329, Tietz NW, editor: Clinical guide to laboratory tests, ed 3, ratory data: style specifications and conversion tables,
1986. Philadelphia, 1995, WB Saunders. Ann Intern Med 106:114, 1987.
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