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Comparison of end-tidal carbon monoxide measurements with direct antiglobulin tests in the management of neonatal hyperbilirubinemia

Journal of Perinatology volume 40, pages 1513–1517 (2020)Cite this article

Subjects

Abstract

Objective

Determine whether management of neonatal hyperbilirubinemia differs if one used end-tidal carbon monoxide (CO) corrected for ambient CO (ETCOc) 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 ETCOc 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 ETCOc, while 29.1% of DAT (−) infants were hemolyzing based on ETCOc. Management of 18 (9.4%) infants differed depending if ETCOc or DAT were used to determine hemolysis. Eight fewer infants would have received phototherapy if ETCOc was used.

Conclusions

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

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Acknowledgements

The authors would like to acknowledge Andrew Paoletti for his assistance with statistics.

Author information

Authors and Affiliations

  1. Department of Neonatology, Baylor College of Medicine, Houston, TX, USA

    A. L. Elsaie

  2. Department of Pediatrics, Einstein Medical Center Philadelphia, Philadelphia, PA, USA

    M. Taleb, K. Newton & D. L. Schutzman

  3. Division of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA

    A. Nicosia

  4. Division of Neonatology, SUNY Downstate, Brooklyn, NY, USA

    A. Zangaladze

  5. Department of Neonatology, Saint Christopher’s Hospital for Children, Philadelphia, PA, USA

    M. E. Pease

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  1. A. L. Elsaie
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  2. M. Taleb
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  6. K. Newton
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  7. D. L. Schutzman
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Contributions

DLS was responsible for the study concept, design, data interpretation, and preparation of the manuscript. ALE and MT were responsible for the study design, data collection and interpretation, and critical review of the manuscript. AN, AZ, MEP, and KN were responsible for data collection, interpretation, and critical review of the manuscript.

Corresponding author

Correspondence to D. L. Schutzman.

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The authors declare that they have no conflict of interest.

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Elsaie, A.L., Taleb, M., Nicosia, A. et al. Comparison of end-tidal carbon monoxide measurements with direct antiglobulin tests in the management of neonatal hyperbilirubinemia. J Perinatol 40, 1513–1517 (2020). https://doi.org/10.1038/s41372-020-0652-y

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