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Carboxyhemoglobin - the forgotten parameter of neonatal hyperbilirubinemia

Bailey, Douggl G.N. ; Fuchs, Hans ; Hentschel, Roland

In: Journal of Perinatal Medicine, 2017, vol. 45, no. 5, p. 613-617

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    Titre
    • Carboxyhemoglobin - the forgotten parameter of neonatal hyperbilirubinemia
    Auteur
    • Bailey, Douggl G.N.. Children's Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006 St Gallen, Switzerland, Tel.: +41 71 243 7111
    • Fuchs, Hans. Division of Neonatology/Intensive Care Medicine, Center for Pediatrics and Adolescent Medicine, University of Freiburg, Freiburg, Germany
    • Hentschel, Roland. Division of Neonatology/Intensive Care Medicine, Center for Pediatrics and Adolescent Medicine, University of Freiburg, Freiburg, Germany
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Journal of Perinatal Medicine, 2017, vol. 45, no. 5, p. 613-617. De Gruyter
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:331446
    Summary
    AbstractBackground: Neonatal hyperbilirubinemia is influenced by a wide variety of factors, one of which is hemolysis. Serious hyperbilirubinemia may lead to a kernicterus with detrimental neurologic sequelae. Patients suffering from hemolytic disease have a higher risk of developing kernicterus. Carbon monoxide (CO), a byproduct of hemolysis or heme degradation, was described by Sjöstrand in the 1960s. It is transported as carboxyhemoglobin (COHb) and exhaled through the lungs. We were interested in a potential correlation between COHb and total serum bilirubin (TSB) and the time course of both parameters. Materials and methods: We used a point of care (POC) blood gas analyzer and did a retrospective analysis of bilirubin and COHb data collected over a 60-day period. Results: An arbitrary cut-off point set at 2% COHb identified four patients with hemolytic disease of different origins who required phototherapy. In one patient with atypical hemolytic uremic syndrome (aHUS), COHb preceded the rise in bilirubin by about 2 days. Despite this displacement, there was a moderately good correlation of COHb with TSB levels <15 mg/dL (257 μmol/L) (r2: 0.80) and direct bilirubin (r2: 0.78) in the first patient. For all the four patients and all time points the correlation was slightly lower (r2: 0.59). Conclusions: COHb might be useful as a marker for high hemoglobin turnover to allow an earlier identification of newborns at risk to a rapid rise in bilirubin.