Sophisticated automated instrumentation makes it possible to conduct a wide variety of chemical tests on a single sample of blood and to report results in a timely manner. Numerical results may be reported with low, high, panic (or critical values), toxic, or D (i.e., fails Delta check) comments along with normal reference range. Computerized interfaces allow direct transmission of results between laboratory and clinical settings. Not only does this method of record keeping provide a baseline for future comparisons, but it can also allow unsuspected diseases to be uncovered and can lead to early diagnosis when symptoms are vague or absent. Chemistry tests may be grouped into lipid, basic metabolic, comprehensive metabolic, hepatic, or electrolyte panels. A list of standard panels appears in Table 6.2.
Normal or reference values (intervals) for any chemistry determination vary with the method or assay used. For example, differences in substrates or temperature at which the assay is run will alter the normal range. Thus, normal ranges vary from laboratory to laboratory.