Increased Carbon Monoxide Washout Rates in Newborn Infants.

Abstract:

BACKGROUND:Endogenous carbon monoxide (CO) production is primarily due to heme degradation, which also results in the equimolar production of bilirubin. Thus, estimates of total body CO production can serve as indices of total body bilirubin formation. The elimination rate of CO from a person's body (CO washout rate) after exposure to an elevated ambient CO concentration is determined by a variety of factors, and is very different between babies and adults. OBJECTIVE:We determined CO washout rates for babies using a simplified technique to measure total body CO excretion rates (VeCO). METHODS:Using a simplified technique, we measured the times to reach an approximate steady state after a change in ambient CO concentration (decay time constant) and CO washout rates in normal newborn infants using non-linear least squares curve fitting. RESULTS:We found a mean CO washout time of 18.7 ± 4.2 min and a CO equilibration (decay time) constant of 0.12 ± 0.04/min (0.08-0.21) for newborn infants. CONCLUSIONS:We confirm that CO washout rates for babies are much faster than those for adults. Therefore, measurements of carboxyhemoglobin (COHb) or end-tidal CO (ETCO), corrected for ambient CO, (COHbc and ETCOc, respectively) can be used as surrogates for VeCO and can provide accurate estimates of endogenous CO (VCO) and bilirubin production rates under normal environmental conditions. Such measurements can be used to identify infants with severe hyperbilirubinemia due to hemolysis and thus at high risk for bilirubin neurotoxicity.

journal_name

Neonatology

journal_title

Neonatology

authors

Stevenson DK,Wong RJ,Ostrander CR,Maric I,Vreman HJ,Cohen RS

doi

10.1159/000503635

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

118-122

issue

1

eissn

1661-7800

issn

1661-7819

pii

000503635

journal_volume

117

pub_type

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