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The guideline recommends starting phototherapy at a lower level than otherwise if significant hemolysis is present. Currently, the optimal way to measure hemolysis is by determining an infant\u2019s level of end-tidal carbon monoxide corrected for ambient carbon monoxide (ETCOc). However, it is unclear what the optimal ETCOc level is for determining significant hemolysis. Given the differences in ETCOc levels among infants of different backgrounds, the most reasonable conclusion would be for each unit to determine the mean\u2009\u00b1\u2009standard deviation ETCOc level of an inclusive group of 200\u2013500 infants in their unit. Each unit could then decide whether to use the 95th, 75th, or some other percentile value as their unit\u2019s indicator of significant hemolysis.<\/jats:p>","DOI":"10.1038\/s41372-026-02921-5","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:07:16Z","timestamp":1790773636000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["End tidal carbon monoxide and significant hemolysis"],"prefix":"10.1038","author":[{"given":"David L.","family":"Schutzman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"2921_CR1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-058859","volume":"150","author":"AR Kemper","year":"2022","unstructured":"Kemper AR, Newman TB, Slaughter JL, Maisels MJ, Watchko JF, Downs SM, et al. 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