Cosyntropin (ACTH) Stimulation Study, Baseline

Sunquest Code:CORTB  
Epic Code:LAB3407Epic Name:Cort Stim Baseline
Order Instructions:CORTB, CORT30 and CORT60 must be ordered on 3 different accession numbers because they have different collection times. If 15 minute cortisol is requested, order CORT.
Methodology:Chemiluminescent immunoassay
Turnaround Time:Performed and reported 24 hours/day.
Special Instructions:Please contact the laboratory to coordinate timed specimen collections prior to giving Cosyntropin.

Collection Instructions

Optimal Volume:2.5 mL
Minimum\Peds Volume:0.6 mL
Container:Red or gold (gel) (Red (no gel))
Collection Instructions:
Time Test Collection Requirements Collection Instructions
Baseline   Cortisol   Collect 2 mL, 0.6 mL minimum in a red or gold (gel or no gel) tube Collect before giving Cosyntropin dose, Record collect time on specimen.   Renin: Collect mid-morning after patient has been sitting, standing or walking for at least 2 hours and seated for 5-15 minutes. Normal sodium diet (100-200 mEq/day) for at least three days. Receiving no medications known to affect renin-aldosterone system.
ACTH Collect 2 mL, 0.5 mL minimum in a purple (EDTA) tube on ice
Optional: Renin   Collect 4 mL, 2.6 mL in purple tube. Do NOT place on ice.  
Optional: Electrolyte Panel   Collect 2.5, 0.6 mL in green (lithium heparin) tube.
15 minutes Cortisol, if ordered by provider Collect 2 mL, 0.6 mL minimum in a red or gold (gel or no gel) tube  
30 minutes Cortisol   Collect 2 mL, 0.6 mL minimum in a red or gold (gel or no gel) tube  
60 minutes Cortisol Collect 2 mL, 0.6 mL minimum in a red or gold (gel or no gel) tube  
Causes for Rejection:Baseline sample not drawn immediately prior to giving Cosyntropin.

Processing and Shipping

Specimen Processing:Centrifuge and aliquot 1.25 mL, 0.2 mL minimum. Store in refrigerator.
Shipping Instructions:Ship at refrigerated temperature to arrive within 48 hours of collection. Alternately ship on dry ice..
Stability:Stability: Room temperature - 8 hours; refrigerated - 48 hours; frozen - indefinitely.
Test Performed at or Referral Lab Chemistry  (UMMC-East Bank)


Critical Range:>150.0 µg/dL
Reference Range:

Baseline:                       8 AM

                                     4 PM

4-22 mg/dL

3-17 mg/dL

30 minutes post stimulation

Greater than 20 mg/dL

60 minutes post stimulation

Greater than 20 mg/dL



Limitations:Circulating cortisol results from patients receiving Prednisolone or Prednisone therapy may be falsely elevated. Exercise caution with cortisol determinations for patients undergoing therapy with these and structurally related synthetic corticosteroids.
Use:Best used for evaluation of adequacy of adrenal response to stimulation by ACTH.

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