"Measuring End-Tidal Carbon Monoxide of Jaundiced Neonates in the Birth" by Robert D Christensen, Daniel T Malleske MD, MS et al.
 

Measuring End-Tidal Carbon Monoxide of Jaundiced Neonates in the Birth Hospital to Identify Those with Hemolysis.

Publication/Presentation Date

1-1-2016

Abstract

BACKGROUND: End-tidal breath carbon monoxide (ETCOc) levels correlate with catabolism of heme, but until recently, this measurement was not readily available for application to neonatology practice.

OBJECTIVES: We performed a prospective, multihospital, test-of-concept study where ETCOc was measured during the birth hospitalization of neonates with a total bilirubin (TB) value >75th percentile on the Bhutani bilirubin nomogram. This was done to test the feasibility and ease of use of this new device.

METHODS: Neonates with an elevated ETCOc (with a >95th percentile reference interval previously established) were labeled as having 'hemolytic jaundice'. We recommended a follow-up TB checkfamilies.

RESULTS: One hundred and fifteen neonates were eligible for the study, the parents of 103 provided consent, and measurements were obtained for 100. Sixty-three had normal and 37 had elevated ETCOc values. By means of a direct antiglobulin test (DAT; Coombs), 11 of these 37 were found positive for ABO hemolytic disease; the remaining 26 had other etiologies. Thirty-six of the 37 with an elevated ETCOc had repeat TB monitoring75th percentile (p = 0.079).

CONCLUSION: ETCOc measurement is a feasible means of assessing hemolysis in jaundiced neonates during the birth hospitalization. When hemolysis is identified, parents are likely to comply with instructions to bring the infant for a TB checkuphome.

Volume

109

Issue

1

First Page

1

Last Page

5

ISSN

1661-7819

Disciplines

Medicine and Health Sciences | Pediatrics

PubMedID

26394287

Department(s)

Department of Pediatrics

Document Type

Article

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