Correlation Between Levels Of Non-invasive Measurement Of Carboxyhemoglobin And Bilirubin In Term And Near Term Neonates As A Predictor Of Neonatal Hemolysis | 109333
Neonatal and Pediatric Medicine
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Background: Neonatal hyperbilirubinemia is common in the neonatal period. Yet, serious pathological
hyperbilirubinemia may cause detrimental neurologic sequalae. Carbon monoxide is the byproduct
of the breakdown of heme, it is transported as carboxyhemoglobin to the lungs to be exhaled. Thus,
carboxyhemoglobin levels increase as a result of hemolysis, and is therefore considered a sensitive index for
the degree and severity of the subsequent hyperbilirubinemia.
Objectives: To correlate between non-invasive measurements of carboxyhemoglobin levels and bilirubin
levels in near-term and term neonates starting hour one of life.
Subjects and methods: A total of 100 near-term and term neonates were studied, by measuring
carboxyhemoglobin by a Pulse Co-oximetry and serum bilirubin level (hour1) as well as transcutaneous
bilirubin (TcB) hourly since birth for the 1st 6 hours then every 6 hours till the time of discharge in a cross
sectional case-control study.
Results: A cut off value of 4 for non-invasive carboxyhemoglobin with sensitivity of 81.25%, specificity of
95.24% was found to the earliest noninvasive predictor for subsequent jaundice. In patients with proven
hemolysis, carboxyhemoglobin when compared to TcB was found to increase significantly in the first 3 hours
of life more than TcB. Starting hour 4 postnatally, it was increased yet statistically insignificant
Conclusion: We found that non-invasive measurement of carboxyhemoglobin is an effective early predictor
for subsequent jaundice starting first hour of life. It can be used as a screening tool for hemolytic jaundice
especially in hospitals with early discharge policy.
Basma M. Shehata is a Lecturer of Pediatrics and Neonataology, Faculty of medicine, Ain Shams University since 2017 after completing the MD. She is a certified Neonatal Life Support instructor from the European Resuscitation Council
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