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Updated: May 1, 2026

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department

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Published on: January 29, 2011

End-tidal carbon monoxide and hemolysis.

G F Tidmarsh¹, R J Wong¹, D K Stevenson¹

¹Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association

|April 19, 2014

Summary

End-tidal carbon monoxide (ETCOc) measurements can identify newborns at risk for severe hyperbilirubinemia due to hemolysis. This non-invasive method tracks heme breakdown, aiding early detection and management of at-risk infants.

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Area of Science:

Neonatal Medicine
Biochemistry
Pulmonary Medicine

Background:

Hemolytic disease in newborns increases the risk of severe hyperbilirubinemia.
Heme breakdown produces carbon monoxide (CO) and bilirubin in equimolar amounts.
Detecting hemolysis in neonates is clinically challenging.

Purpose of the Study:

To highlight the significance of end-tidal carbon monoxide (ETCOc) measurements.
To demonstrate the application of ETCOc in identifying infants at risk for hyperbilirubinemia.
To establish ETCOc as an index of hemolysis and bilirubin production.

Main Methods:

Measurement of end-tidal CO (ETCOc), corrected for ambient CO.
Correlation of ETCOc levels with blood carboxyhemoglobin levels.
Utilizing ETCOc as an indicator of hemolysis and bilirubin production.

Main Results:

Elevated ETCOc levels correlate with increased carboxyhemoglobin and hemolysis.
ETCOc serves as a reliable index for hemolysis in newborns.
ETCOc aids in assessing bilirubin production from various causes.

Conclusions:

ETCOc measurement is crucial for identifying neonatal hemolysis.
This method helps identify infants at risk for hyperbilirubinemia.
ETCOc offers a valuable, non-invasive tool for neonatal care.