在新生儿高胆红素血症管理中，潮气末一氧化碳测量与直接抗球蛋白试验的比较。
Comparison of end-tidal carbon monoxide measurements with direct antiglobulin tests in the management of neonatal hyperbilirubinemia.
作者信息
Elsaie A L, Taleb M, Nicosia A, Zangaladze A, Pease M E, Newton K, Schutzman D L
机构信息
Department of Neonatology, Baylor College of Medicine, Houston, TX, USA.
Department of Pediatrics, Einstein Medical Center Philadelphia, Philadelphia, PA, USA.
出版信息
J Perinatol. 2020 Oct;40(10):1513-1517. doi: 10.1038/s41372-020-0652-y. Epub 2020 Mar 19.
OBJECTIVE
Determine whether management of neonatal hyperbilirubinemia differs if one used end-tidal carbon monoxide (CO) corrected for ambient CO (ETCO) measurements instead of direct antiglobulin test (DAT) results to assess the severity of hemolysis.
STUDY DESIGN
Retrospective chart review of infants with total bilirubin and ETCO levels measured from July 2016 to August 2018. The reported treatment is the hypothetical management infants might have received had there been strict adherence to American Academy of Pediatrics guidelines, rather than the actual management they received.
RESULT
Only 27.2% of 191 DAT(+) infants were hemolyzing based on ETCO, while 29.1% of DAT (-) infants were hemolyzing based on ETCO. Management of 18 (9.4%) infants differed depending if ETCO or DAT were used to determine hemolysis. Eight fewer infants would have received phototherapy if ETCO was used.
CONCLUSIONS
ETCO is a more accurate determinant of hemolysis in the newborn, and its use can lead to less phototherapy.
目的
确定如果使用经环境一氧化碳（CO）校正的潮气末一氧化碳（ETCO）测量值而非直接抗球蛋白试验（DAT）结果来评估溶血严重程度，新生儿高胆红素血症的管理是否会有所不同。
研究设计
对2016年7月至2018年8月期间测量了总胆红素和ETCO水平的婴儿进行回顾性病历审查。报告的治疗方法是假设婴儿严格遵循美国儿科学会指南可能接受的治疗，而非他们实际接受的治疗。
结果
在191名DAT（+）婴儿中，仅27.2%基于ETCO存在溶血，而在DAT（-）婴儿中，29.1%基于ETCO存在溶血。18名（9.4%）婴儿的管理因使用ETCO还是DAT来确定溶血而有所不同。如果使用ETCO，接受光疗的婴儿将减少8名。
结论
ETCO是新生儿溶血更准确的决定因素，使用它可减少光疗。
Zotero 插件