Neonatal/perinatal diagnosis of hemolysis using ETCOc.

Abstract

Hemolysis is a pathological shortening of the red blood cell lifespan. When hemolysis occurs in a neonate, hazardous hyperbilirubinemia and severe anemia could result. Hemolysis can be diagnosed, and its severity quantified, by the non-invasive measurement of carbon monoxide (CO) in exhaled breath. The point-of-care measurement is called "End-tidal CO corrected for ambient CO" (ETCOc). Herein we explain how ETCOc measurements can be used to diagnose and manage various perinatal/neonatal hemolytic disorders. We provide information regarding five clinical situations; 1) facilitating a precise diagnosis among neonates presenting with anemia or jaundice of unknown etiology, 2) monitoring fetal hemolysis with serial measurements of mothers during pregnancy, 3) measuring the duration of hemolysis in neonates with hemolytic disease, 4) measuring neonates who require phototherapy, to determine whether they have hemolytic vs. non-hemolytic jaundice, and 5) measuring all neonates in the birth hospital as part of a jaundice-detection and management program.