title: Point-of-care end-tidal carbon monoxide reflects severity of hemolysis in sickle cell anemia.
abstract: Carbon monoxide (CO) production from heme catabolism is increased with hemolysis. A portable end-tidal CO (ETCO) monitor was used to analyze breath samples in 16 children with sickle cell anemia (SCA, 5-14 years). Median (range) ETCO for SCA was 4.35 ppm (1.8-9.7) versus 0.80 ppm (0.2-2.3) for controls (P < 0.001). ETCOc >2.1 ppm provided sensitivity and specificity of 93.8% (69.8-99.8%) for detecting SCA. ETCO correlated with reticulocytosis (P = 0.015) and bilirubin (P = 0.009), and was 32% lower in children receiving hydroxyurea (P = 0.09). Point-of-care ETCO analysis may prove useful for non-invasive monitoring of hemolysis and as a screening test for SCA.
authors: Hematology/Oncology, University of California San Francisco Benioff Children's Hospital, Oakland, California.
authors: Ashutosh
authors: A
authors: Lal
authors: Lasandra
authors: L
authors: Patterson
authors: Alisa
authors: A
authors: Goldrich
authors: Anne
authors: A
authors: Marsh
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000503:physiopathology*; D001663:Bilirubin / Q000032:analysis; D002248:Carbon Monoxide / Q000032:analysis*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D045853:Exhalation / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006461:Hemolysis; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation; D010865:Pilot Projects; D019095:Point-of-Care Systems; D011379:Prognosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013990:Tidal Volume
chemical_list: D002248:Carbon Monoxide; D001663:Bilirubin
keywords: hemoglobinopathies; red blood cell disorders; sickle cell anemia