Bilirubin production in healthy term infants as measured by carbon monoxide in breath.
To describe total bilirubin production in healthy term infants, we measured the end-tidal breath CO, corrected for ambient CO (ETCOc), with an automated sampler and electrochemical (EC) CO instrument. For infants of mothers with a negative Coombs' test, the ETCOc was 1.3 +/- 0.7 microL/L (n = 397) and the serum bilirubin on day 3 postpartum was 73 +/- 35 mg/L (n = 381). In contrast, the ETCOc for infants with ABO or Rh incompatibility, a positive direct Coombs' test, and bilirubin > 130 mg/L (n = 9) was significantly higher, 1.8 +/- 0.8 microL/L, than for those who had a positive Coombs' test result but whose bilirubin was < or = 130 mg/L (n = 12), 1.0 +/- 0.5 microL/L (P < 0.05). At 2 to 8 h postpartum seven term babies from mothers with insulin-dependent diabetes had ETCOc of 1.8 +/- 0.7 microL/L, significantly higher than that in the other term infants [1.3 +/- 0.7 microL/L (n = 390), P < 0.04]. Their bilirubin concentration at 72 +/- 12 h was also higher: 121 +/- 45 mg/L (n = 7) vs 73 +/- 34 mg/L (n = 374; P = 0.03). We conclude that ETCOc measurements may be helpful in understanding the mechanisms of jaundice in healthy term infants in a variety of conditions.
Stevenson
D K
DK
Department of Pediatrics, Stanford University School of Medicine, CA 94305-54119.
Vreman
H J
HJ
Oh
W
W
Fanaroff
A A
AA
Wright
L L
LL
Lemons
J A
JA
Verter
J
J
Shankaran
S
S
Tyson
J E
JE
Korones
S B
SB
D001213:Asian; D001663:Bilirubin / Q000096:biosynthesis* / Q000097:blood; D044383:Black People; D001942:Breast Feeding; D001944:Breath Tests / Q000295:instrumentation / Q000379:methods; D002248:Carbon Monoxide / Q000032:analysis*; D003298:Coombs Test; D004563:Electrochemistry; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007231:Infant, Newborn / Q000378:metabolism*; D007567:Jaundice, Neonatal / Q000378:metabolism; D008297:Male; D012907:Smoking; D044465:White People
D002248:Carbon Monoxide; D001663:Bilirubin