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CATFP / CATP-M
CATECHOLAMINE FRACTIONATION, PLASMA, FREE

Test Code CATFP / CATP-M 
Test CATECHOLAMINE FRACTIONATION, PLASMA, FREE 
Methodology High Pressure Liquid Chromatography (HPLC) 
Description Includes unconjugated norepinephrine, epinephrine, and dopamine.

Useful in the diagnosis of pheochromocytoma and paraganglioma, as an auxiliary test to fractionated plasma and urine metanephrine measurements, in the diagnosis and follow-up of patients with neuroblastoma and related tumors, as an auxiliary test to urine VMA and HVA, and in the evaluation of patients with autonomic dysfunction/failure or autonomic neuropathy 

Specimen Collection Container/Tube: Catecholamine tubes containing EDTA-sodium metabisulfite solution (Supply T066) (tubes have a 6-month expiration time)
Submission Container/Tube: Plastic vial
Specimen Volume: 3 mL
Collection Instructions:
1. Drawing from a catheter is required.
2. Unless the purpose of the measurement is drug monitoring, discontinue any epinephrine, norepinephrine, or dopamine injections/infusions for at least 12 hours before specimen draw.
3. Discontinue drugs that release epinephrine, norepinephrine, or dopamine or hinder their metabolism for at least 1 week before obtaining the specimen (see Cautions for details). If this is not possible for medical reasons, contact the laboratory and discuss whether a shorter drug-withdrawal period may be possible in a particular case.
4. Do not perform the test on patients withdrawing from legal or illegal drugs known to cause rebound plasma catecholamine release during withdrawal (see Cautions for details).
5. The patient must refrain from eating, using tobacco, and drinking caffeinated beverages for at least 4 hours before the specimen is drawn.
6. Calm the patient by giving complete instructions and reassurance regarding the procedure.
7. Insert an indwelling intravenous catheter. Flush with 3 mL of NaCl, using positive pressure.
8. Have the patient rest for 30 minutes in the supine position in a quiet room.
9. At the end of the 30 minutes, withdraw and discard a minimum of 3 mL of blood to remove the saline out of the catheter.
10. If provocative sampling (eg, standing specimen) is required, perform provocative maneuver immediately after obtaining supine specimen. Obtain standing specimen immediately.
11. For each specimen, draw 10 mL (minimum 2mL) of blood into the chilled EDTA-sodium metabisulfite 10-mL tube.
12. Separate plasma in a refrigerated centrifuge within 30 minutes of draw.
13. Freeze specimen immediately 
Reference Values NOREPINEPHRINE
Supine: 70 - 750 pg/mL
Standing: 200 - 1700 pg/mL

EPINEPHRINE
Supine: Undetectable - 110 pg/mL
Standing: Undetectable - 140 pg/mL

DOPAMINE
< 30 pg/mL (no postural change) 

Analytic Time 2 Days 
Day(s) Test Set Up Monday through Friday 
CPT Code(s) 82384