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Higher ETCOc predicts longer phototherapy treatment in neonatal hyperbilirubinemia

Yuan-Li Zhan1, Hai-Bo Peng1, Zhen-Chao Jin1

  • 1Department of Neonatology, Affiliated Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China.

Frontiers in Pediatrics
|April 28, 2023
PubMed

Insights

End-tidal carbon monoxide corrected to ambient carbon monoxide (ETCOc) can predict phototherapy duration in neonates with hyperbilirubinemia. This non-invasive measure aids in assessing disease severity and improving clinical communication.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Biomedical Engineering

Background:

  • Neonatal hyperbilirubinemia is a common condition requiring phototherapy.
  • Predicting the duration of phototherapy is crucial for managing infant care and resource allocation.
  • Current methods for predicting phototherapy duration have limitations.

Purpose of the Study:

  • To evaluate the predictive performance of end-tidal carbon monoxide corrected to ambient carbon monoxide (ETCOc) for phototherapy duration in neonates.
  • To determine if ETCOc levels at admission can indicate the likelihood of prolonged phototherapy.
  • To assess the clinical utility of ETCOc in managing hyperbilirubinemia.

Main Methods:

  • A prospective study involving 103 neonates with significant hyperbilirubinemia receiving phototherapy.
  • Measurement of ETCOc and serum total bilirubin on admission.
  • Categorization of neonates based on phototherapy duration (≤72 hours vs. >72 hours).

Main Results:

  • The mean ETCOc at admission was 1.70 ppm.
  • Neonates requiring >72 hours of phototherapy had significantly higher ETCOc levels (2.45 ppm vs. 1.60 ppm, P=0.001).
  • An ETCOc cutoff of 2.4 ppm demonstrated 62.5% sensitivity and 88.5% specificity for predicting longer phototherapy duration.

Conclusions:

  • ETCOc is a valuable non-invasive biomarker for predicting phototherapy duration in neonates with hyperbilirubinemia.
  • Higher ETCOc levels at admission are associated with a longer need for phototherapy.
  • Utilizing ETCOc can assist clinicians in judging disease severity and enhancing communication.
Abstract

Keywords:
ETCOchyperbilirubinemianeonatesphototherapypredict

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