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End-tidal carbon monoxide in newborn infants: observations during the 1st week of life
V Balaraman1, S Pelke, S DiMauro
1Department of Pediatrics, Kapiolani Medical Center for Women and Children and the University of Hawaii, Honolulu, Hawaii, USA.
Insights
Serial measurements of end-tidal carbon monoxide corrected for ambient CO (ETCOc) in newborns showed a decrease over the first five days. ETCOc levels did not predict hyperbilirubinemia and were inversely related to serum bilirubin.
Area of Science:
- Neonatal physiology
- Bilirubin metabolism
- Respiratory gas analysis
Background:
- Transitional hyperbilirubinemia is common in newborns.
- End-tidal carbon monoxide corrected for ambient CO (ETCOc) reflects endogenous CO production.
- Previous research on ETCOc in neonates is limited.
Purpose of the Study:
- To investigate serial ETCOc levels in normal newborn infants during the first five days of life.
- To determine the relationship between ETCOc, ethnicity, and serum bilirubin levels.
- To assess the utility of ETCOc in predicting the course of transitional hyperbilirubinemia.
Main Methods:
- Serial measurements of ETCOc were performed in 87 normal newborn infants.
- Infants were monitored during the first 5 days of life.
- Data were analyzed for correlations with ethnicity and serum bilirubin levels.
Main Results:
- ETCOc levels progressively decreased from 1.6 +/- 0.4 ppm to 0.8 +/- 0.2 ppm over the first 5 days.
- No significant relationship was found between ETCOc levels and infant ethnicity.
- ETCOc levels showed an inverse correlation with serum bilirubin levels.
Conclusions:
- Serial ETCOc measurements in newborns show a declining trend in the first week of life.
- ETCOc levels are not influenced by ethnicity in this population.
- ETCOc is not a reliable predictor for the course of transitional hyperbilirubinemia in normal newborns.
Abstract:
Serial end-tidal carbon monoxide corrected for ambient CO (ETCOc) levels were measured in an ethnically diverse population of 87 normal newborn infants during the first 5 days of life. The results demonstrate a progressive reduction in ETCOc from 1.6 +/- 0.4 to 0.8 +/- 0.2 ppm. These levels were unrelated to ethnicity, but were inversely related to serum bilirubin levels. We conclude that ETCOc is not a useful indicator for predicting the course of transitional hyperbilirubinemia in the normal newborn infant.