To Investigate the Laboratory Sample Criteria of Ammonia Measurement in Saudi Arabia.

Objective: The aim of this study was to investigate the laboratory sample acceptance criteria, ammonia analysis, and the reporting of ammonia results and raise awareness of the new guidelines.

Methods: It is a descriptive cross-sectional study. The study was conducted in the clinical laboratories of the hospital, KSA. Furthermore, the study used electronic questionnaires. A questionnaire was distributed to clinical biochemistry laboratories in Saudi Arabia. The results were collected and compared to updated best practice guidelines on hyperammonemia issued by the Metabolic Biochemistry Network (MetBio.net).

Results: This study examined laboratory practices in ammonia analysis. EDTA tubes are widely used (78.0%) for blood/plasma ammonia measurement. Most laboratories prioritize sample delivery on ice (100%) and fast-track samples for ammonia analysis (95.1%). Awareness of ammonia analysis criteria includes automated methods for hemolysis assessment (61.0%) and rejection of grossly hemolyzed samples (92.7%). The enzymatic method is predominant (97.6%). Concerns about icterus and lipemia impact (80.5% and 85.4%, respectively) are noted. Reporting practices vary, with 65.9% setting specific thresholds for critical limits.

Conclusion: This study offers insights into current ammonia analysis practices, identifying areas for improvement. Aligning with literature, it emphasizes the need for ongoing education and guideline updates for consistent and accurate severe hyperammonemia diagnosis and management.