Identification of neonatal haemolysis: an approach to predischarge management of neonatal hyperbilirubinemia

Aim Relative contributions of increased production [by end‐tidal carbon monoxide concentrations (ETCOc)] and decreased elimination of bilirubin to predischarge hour‐specific total bilirubin (TB) levels were assessed in healthy late‐preterm and term newborns. Secondly, we report predischarge ETCOc ra...

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Bibliographic Details
Published in:Acta Paediatrica 2016-05, Vol.105 (5), p.e189-e194
Main Authors: Bhutani, Vinod K., Srinivas, Shanmukha, Castillo Cuadrado, Martin E., Aby, Janelle L., Wong, Ronald J., Stevenson, David K.
Format: Article
Language:English
Subjects:
Algorithms
Bilirubin
Bilirubin - blood
Bilirubin elimination
Bilirubin production
Biomarkers - metabolism
Carbon Monoxide - metabolism
Clinical Decision-Making
Decision Support Techniques
End-tidal carbon monoxide
Female
Hemolysis
Humans
Hyperbilirubinemia, Neonatal - diagnosis
Hyperbilirubinemia, Neonatal - etiology
Hyperbilirubinemia, Neonatal - metabolism
Infant, Newborn
Male
Newborn jaundice
Patient Discharge
Point-of-Care Testing
Reference Values
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Summary:Aim Relative contributions of increased production [by end‐tidal carbon monoxide concentrations (ETCOc)] and decreased elimination of bilirubin to predischarge hour‐specific total bilirubin (TB) levels were assessed in healthy late‐preterm and term newborns. Secondly, we report predischarge ETCOc ranges to guide clinical management of hyperbilirubinemia. Methods TB and ETCOc (≤3 timepoints) determinations of newborns aged between six hours and 75th percentile (n = 31), 23% had ETCO ≤1.5, and 77% had ETCOc > 1.5 (p < 0.00003). Conclusion Near‐simultaneous ETCOc and TB measurements in infants with TB >75th percentile accurately identify haemolytic hyperbilirubinemia.
ISSN:0803-5253
1651-2227
DOI:10.1111/apa.13341