title: The role of carboxyhemoglobin measured with CO-oximetry in the detection of hemolysis in newborns with ABO alloimmunization.
abstract: OBJECTIVE
  To evaluate carboxyhemoglobin (COHb) values measured with a CO-oximeter (Roche-cobas b 221) in jaundiced newborns with or without hemolysis and healthy controls in order to assess whether COHb measurement determined with a CO-oximeter could be used as an indicator of hemolysis in newborns with ABO alloimmunization.
  
  
  METHODS
  A total of 86 term newborn infants were prospectively studied. The study cohort consisted of three subgroups: 18 infants with ABO HDN, 21 infants with hyperbilirubinemia without hemolytic disease who required phototherapy, and 47 healthy controls. The COHb, bilirubin, and Hb levels were measured.
  
  
  RESULTS
  The three subgroups did not differ significantly with respect to birth weight, gestational age, gender, Apgar score, or mode of delivery. The ABO HDN infants had significantly higher COHb values than the healthy controls (median 2.4% versus 1.3%, p < 0.0005) and the group with hyperbilirubinemia without hemolytic disease (median 2.4% versus 1.3%, p < 0.0005), although the infants with hyperbilirubinemia without hemolytic disease did not have significantly higher COHb values compared with the healthy controls. The cut-off value of 1.7% COHb had 72% sensitivity and 97% specificity for confirming hemolysis in ABO alloimmunization.
  
  
  CONCLUSIONS
  Our data show that COHb values determined with CO-oximeters are higher in newborns with hemolysis than in those without hemolysis. COHb measured with CO-oximeters could be used to confirm hemolysis in infants with ABO alloimmunization.
authors.affiliation: a Division of Pediatrics, Department of Neonatology , University Medical Centre Ljubljana , Ljubljana , Slovenia.
authors.forename: Jana
authors.initials: J
authors.lastname: Lozar-Krivec
authors.affiliation: a Division of Pediatrics, Department of Neonatology , University Medical Centre Ljubljana , Ljubljana , Slovenia.
authors.forename: Borut
authors.initials: B
authors.lastname: Bratanic
authors.affiliation: a Division of Pediatrics, Department of Neonatology , University Medical Centre Ljubljana , Ljubljana , Slovenia.
authors.forename: Darja
authors.initials: D
authors.lastname: Paro-Panjan
mesh_terms: D000017:ABO Blood-Group System; D001787:Blood Group Incompatibility / Q000097:blood*; D002263:Carboxyhemoglobin / Q000378:metabolism*; D005260:Female; D006461:Hemolysis; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010092:Oximetry; D011446:Prospective Studies
chemical_list: D000017:ABO Blood-Group System; D002263:Carboxyhemoglobin
keywords: ABO hemolytic disease; carboxyhemoglobin; hyperbilirubinemia; newborn