The Incubator #286 - [Journal Club Shorts] - 📌 End-Tidal Carbon Monoxide Measurement in Newborns Receiving Phototherapy.
Mar 2, 2025
Timothy Barr, an Assistant Professor in Neonatology at Intermountain Health and faculty at the University of Utah, discusses innovative methods for monitoring newborns. He introduces the non-invasive end-tidal carbon monoxide measurement for assessing hemolysis in infants receiving phototherapy. The conversation delves into the challenges of predicting hemolysis duration, the complexities of bilirubin management, and debates the universal versus selective application for at-risk populations. Barr also touches on the relationship between erythropoietic stimulating agents and carbon monoxide levels.
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CO as Hemolysis Marker
- Carbon monoxide is produced in equimolar amounts with bilirubin during red blood cell breakdown.
- Measuring exhaled end-tidal carbon monoxide provides a non-invasive way to quantify hemolysis in newborns.
Elevated CO Predicts Phototherapy Needs
- In a cohort of about 170 infants, elevated end-tidal CO was linked to earlier and longer phototherapy.
- All babies readmitted for hyperbilirubinemia had elevated end-tidal CO levels.
Screen High-Risk Newborns Early
- Use end-tidal carbon monoxide to risk stratify newborns at risk for hyperbilirubinemia before discharge.
- High end-tidal CO indicates greater risk for severe hyperbilirubinemia and neurotoxicity.