{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:08:49Z","timestamp":1790813329897,"version":"4.1.0"},"reference-count":18,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neonatology"],"published-print":{"date-parts":[[2020]]},"abstract":"<b><i>Background:<\/i><\/b> Hemolytic hyperbilirubinemia due to blood group incompatibility or glucose-6-phosphate dehydrogenase deficiency (G6PD) is a common cause of significant hyperbilirubinemia. Hemolysis in a hyperbilirubinemic infant increases the risk of bilirubin neurotoxicity. A new portable device (CoSense) can rapidly detect breath end-tidal carbon monoxide corrected to ambient carbon monoxide (ETCOc). ETCOc levels are surrogate markers of hemoglobin breakdown and bilirubin production. <b><i>Objective:<\/i><\/b> The aim was to evaluate the association between ETCOc values and hemolysis and its relevance in neonates at risk for significant hyperbilirubinemia. <b><i>Methods:<\/i><\/b> A prospective study was conducted among newborn infants born at more than 35 weeks and with a birth weight greater than 2,000 g with a G6PD deficiency, blood group incompatibility, or clinical jaundice needing phototherapy during the first 7 days of life. The recruited infants had their breath ETCOc measured twice, first on the day of recruitment and then again on the following day. <b><i>Results:<\/i><\/b> Fifty infants completed this study. Their mean ETCOc was 1.61 (\u00b10.56) ppm. There was a linear correlation (<i>r<\/i> = 0.89) between increasing ETCOc values and reticulocyte counts (RC). Sixteen newborns with ABO incompatibility had a significantly higher mean ETCOc of 1.98 ppm (\u00b10.71) as compared to 1.43 (\u00b10.38) ppm in the nonhemolytic hyperbilirubinemia (NHH) group (<i>n<\/i> = 25) (<i>p<\/i> = 0.002). This was suggestive of hemolysis as shown by the significantly higher RC of 6.90% (\u00b13.38) compared to 4.68 (\u00b11.26) in the NHH group (<i>p<\/i> &#x3c;0.005). Neonates with an ETCOc level \u22651.8 ppm had a higher RC, a lower hemoglobin level, higher serum bilirubin levels, and a rapid rise in serum bilirubin and needed a longer duration of phototherapy. ETCOc values \u22651.8 ppm were suggestive of hemolysis (RC \u22656%), with a sensitivity of 90% and a specificity of 83%. <b><i>Conclusion:<\/i><\/b> Higher ETCOc values \u22651.8 ppm are suggestive of hemolysis and they are associated with significant hyperbilirubinemia. <\/jats:p>","DOI":"10.1159\/000509405","type":"journal-article","created":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T21:00:31Z","timestamp":1599512431000},"page":"612-618","source":"Crossref","is-referenced-by-count":26,"title":["Noninvasive Detection of Hemolysis with ETCOc Measurement in Neonates at Risk for Significant Hyperbilirubinemia"],"prefix":"10.1159","volume":"117","author":[{"given":"Ashwani","family":"Bhatia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei\u00a0Chien","family":"Chua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rowena","family":"dela\u00a0Puerta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor\u00a0Samuel","family":"Rajadurai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2020,9,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1053\/sper.2001.23197"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-3413"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2014.08.006"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/40.10.1934"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1172\/JCI104994"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1172\/JCI106463"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.114.1.297"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7210702"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2014.68"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1111\/apa.12938"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1542\/peds.108.1.31"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1542\/peds.112.6.1333"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1998.tb01478.x"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2005.08.015"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70177-X"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1203\/pdr.0b013e31805365c5"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13341"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-3042"}],"container-title":["Neonatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/509405","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/509405","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:46:47Z","timestamp":1745423207000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000509405"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,1,13]]},"published-print":{"date-parts":[[2021,1,19]]}},"URL":"https:\/\/doi.org\/10.1159\/000509405","archive":["Portico"],"relation":{},"ISSN":["1661-7800","1661-7819"],"issn-type":[{"value":"1661-7800","type":"print"},{"value":"1661-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020]]}}}