-Hydroxybutyric dehydrogenase (-HBD, HBD) is an enzyme similar to two isoenzymes of lactic dehydrogenase: LDH₁ and LDH₂. The -HBD test, however, is cheaper and easier to perform than LDH isoenzyme electrophoresis. Moreover, HBD levels remain elevated for 18 days after acute myocardial infarction, providing a diagnosis when the client has delayed seeking treatment or has not had classic signs and symptoms.

Note: Values may vary according to the laboratory performing the test.

• Suspected "silent" myocardial infarction or otherwise atypical myocardial infarction in which the client delayed seeking care:
  • HBD levels remain elevated for 18 days after acute myocardial infarction (i.e., when other cardiac enzymes have returned to normal levels).
• Support for diagnosing other disorders associated with elevated HBD levels (e.g., megaloblastic and hemolytic anemias, leukemias, lymphomas, melanomas, muscular dystrophy, nephrotic syndrome, and acute hepatocellular disease)

Nursing Care Before the Procedure

Client preparation is the same as that for any test involving the collection of a peripheral blood sample (see Appendix I).

A venipuncture is performed and the sample collected in a red-topped tube. The sample should be handled gently to avoid hemolysis and transported promptly to the laboratory.

Nursing Care After the Procedure

Care and assessment after the procedure are the same as for any study involving the collection of a peripheral blood sample.