title: End-tidal carbon monoxide and hemolysis.
abstract: Hemolytic disease in newborns can result from a number of conditions, which can place such infants at an increased risk for the development of severe hyperbilirubinemia. Because the catabolism of heme produces equimolar amounts of carbon monoxide (CO) and bilirubin, measurements of end-tidal breath CO (corrected for ambient CO) or ETCOc can serve as an index of hemolysis as well as of bilirubin production from any cause. Elevated levels of ETCOc have been correlated with blood carboxyhemoglobin levels and thus hemolysis. However, the detection of hemolysis can be a clinically challenging problem in newborns. Here, we describe the importance of determining ETCOc levels and their application in identifying infants at risk for developing hyperbilirubinemia associated with hemolysis and other causes of increased bilirubin production.
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: G F
authors.initials: GF
authors.lastname: Tidmarsh
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Wong
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Stevenson
mesh_terms: D001944:Breath Tests; D002248:Carbon Monoxide / Q000378:metabolism*; D006461:Hemolysis / Q000502:physiology*; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000175:diagnosis* / Q000209:etiology* / Q000378:metabolism; D007231:Infant, Newborn; D013990:Tidal Volume
chemical_list: D002248:Carbon Monoxide
references.citation: J Clin Monit Comput. 1999 Dec;15(7-8):421-7
references.pmid: 12578038
references.citation: Pediatr Res. 2009 Jul;66(1):66-9
references.pmid: 19342986
references.citation: Clin Perinatol. 2006 Jun;33(2):387-410
references.pmid: 16765731
references.citation: N Engl J Med. 2006 May 4;354(18):1889-900
references.pmid: 16672700
references.citation: Overseas Postgrad Med J. 1948 Jul;2(8):485-7
references.pmid: 18870306
references.citation: Free Radic Biol Med. 2004 Oct 15;37(8):1097-104
references.pmid: 15451051
references.citation: JAMA. 2005 Apr 6;293(13):1653-62
references.pmid: 15811985
references.citation: J Perinatol. 2005 Jan;25(1):54-9
references.pmid: 15578034
references.citation: Pediatrics. 2003 Dec;112(6 Pt 1):1333-7
references.pmid: 14654606
references.citation: Pediatrics. 2001 Jul;108(1):31-9
references.pmid: 11433051
references.citation: Neurobiol Dis. 2008 Jan;29(1):30-40
references.pmid: 17869125
references.citation: Clin Chem. 1994 Oct;40(10):1934-9
references.pmid: 7923775
references.citation: Pediatrics. 2009 Mar;123(3):1045-50
references.pmid: 19255038
references.citation: Pediatrics. 1988 Apr;81(4):505-11
references.pmid: 3353184
references.citation: Pediatrics. 2004 Aug;114(2):e213-9
references.pmid: 15286259
references.citation: Adv Pediatr. 1995;42:303-34
references.pmid: 8540431
references.citation: Clin Chim Acta. 2006 Mar;365(1-2):177-82
references.pmid: 16188248
references.citation: Dev Med Child Neurol. 2011 Dec;53(12):1113-8
references.pmid: 21933176
references.citation: Semin Perinatol. 2004 Oct;28(5):334-9
references.pmid: 15686264
references.citation: J Mol Med (Berl). 2007 Oct;85(10):1099-112
references.pmid: 17479230
references.citation: Can J Physiol Pharmacol. 1998 Dec;76(12):1057-65
references.pmid: 10326826
references.citation: J Perinatol. 2009 Feb;29 Suppl 1:S61-7
references.pmid: 19177062
references.citation: Pediatrics. 2004 Jul;114(1):297-316
references.pmid: 15231951
references.citation: J Perinatol. 2001 Dec;21 Suppl 1:S52-5; discussion S59-62
references.pmid: 11803418
references.citation: J Perinatol. 2002 Jul-Aug;22(5):341-7
references.pmid: 12082466
references.citation: Nature. 1949 Oct 1;164(4170):580
references.pmid: 18148861
references.citation: Pediatr Hematol Oncol. 2010 Mar;27(2):112-21
references.pmid: 20201692
references.citation: Clin Chem. 1994 Oct;40(10):1927-33
references.pmid: 7923774
references.citation: Eur J Pediatr. 2005 Mar;164(3):162-5
references.pmid: 15599764
references.citation: Blood. 2006 Oct 15;108(8):2846-9
references.pmid: 16778136
references.citation: J Perinatol. 2005 Dec;25(12):784-7
references.pmid: 16222346
references.citation: J Perinatol. 2002 Oct-Nov;22(7):577-9
references.pmid: 12368976
references.citation: J Lab Clin Med. 1974 Jan;83(1):29-37
references.pmid: 4808654
references.citation: Clin Pediatr (Phila). 1994 Feb;33(2):71-6
references.pmid: 8200159
references.citation: Antioxid Redox Signal. 2011 Apr 15;14(8):1535-50
references.pmid: 20919934
references.citation: Clin Chem. 1988 Dec;34(12):2562-6
references.pmid: 3197302
references.citation: Clin Chem. 1996 Jan;42(1):50-6
references.pmid: 8565232
references.citation: Semin Perinatol. 2011 Jun;35(3):185-91
references.pmid: 21641493