Objective

Determine whether management of neonatal hyperbilirubinemia differs if one used end-tidal carbon monoxide (CO) corrected for ambient CO (ETCO_c) measurements instead of direct antiglobulin test (DAT) results to assess the severity of hemolysis.

Study design

Retrospective chart review of infants with total bilirubin and ETCO_c levels measured from July 2016 to August 2018. The reported treatment is the hypothetical management infants might have received had there been strict adherence to American Academy of Pediatrics guidelines, rather than the actual management they received.

Result

Only 27.2% of 191 DAT(+) infants were hemolyzing based on ETCO_c, while 29.1% of DAT (−) infants were hemolyzing based on ETCO_c. Management of 18 (9.4%) infants differed depending if ETCO_c or DAT were used to determine hemolysis. Eight fewer infants would have received phototherapy if ETCO_c was used.

Conclusions

ETCO_c is a more accurate determinant of hemolysis in the newborn, and its use can lead to less phototherapy.

中文翻译：

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呼气末一氧化碳测量与直接抗球蛋白试验在新生儿高胆红素血症管理中的比较。

客观的

如果使用呼气末一氧化碳 (CO) 校正环境 CO (ETCO _c ) 测量值而不是直接抗球蛋白试验 (DAT) 结果来评估溶血的严重程度，则确定新生儿高胆红素血症的管理是否不同。

学习规划

对2016 年 7 月至 2018 年 8 月测量的婴儿总胆红素和 ETCO _c水平的回顾性图表审查。报告的治疗是婴儿可能接受的假设管理，如果严格遵守美国儿科学会指南，而不是他们接受的实际管理.

结果

191 名 DAT(+) 婴儿中只有 27.2% 基于 ETCO _c发生溶血，而 29.1% 的 DAT (-) 婴儿基于 ETCO _c发生溶血。18 名 (9.4%) 婴儿的管理因使用 ETCO _c或 DAT 来确定溶血而有所不同。如果使用 ETCO _c，接受光疗的婴儿将减少 8 个。

结论

ETCO _c是新生儿溶血的更准确的决定因素，它的使用可以减少光疗。