Plasma ammonia testing quantifies blood ammonia, which is normally cleared by the liver and converted to urea for excretion. When liver function is impaired — as in cirrhosis, hepatic encephalopathy, or urea cycle disorders — ammonia accumulates and can affect brain function.
This test is ordered when patients present with unexplained confusion, lethargy, tremors, or coma, particularly in the setting of known liver disease. It is also used to evaluate infants and children with suspected inherited metabolic disorders. Specimen handling is critical: plasma must be collected on ice and analyzed promptly to prevent falsely elevated results from in vitro ammonia generation.
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