Zhan Yuan-Li, Peng Hai-Bo, Jin Zhen-Chao, Su Jin-Feng, Tan Xiang-Yu, Zhao Lu, Zhang Lian
Department of Neonatology, Affiliated Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China.
Front Pediatr. 2023 Apr 11;11:1154350. doi: 10.3389/fped.2023.1154350. eCollection 2023.
This study aimed to evaluate the predictive performance of end-tidal carbon monoxide corrected to ambient carbon monoxide (ETCOc) values phototherapy in neonates with significant hyperbilirubinemia.
A prospective study was conducted on neonates with significant hyperbilirubinemia who received phototherapy between 3 and 7 days of life. The breath ETCOc and serum total bilirubin of the recruited infants were measured on admission.
The mean ETCOc at admission in 103 neonates with significant hyperbilirubinemia was 1.70 ppm. The neonates were categorized into two groups: phototherapy duration ≤72 h ( = 87) and >72 h ( = 16) groups. Infants who received phototherapy for >72 h had significantly higher ETCOc (2.45 vs. 1.60, = 0.001). The cutoff value of ETCOc on admission for predicting longer phototherapy duration was 2.4 ppm, with a sensitivity of 62.5% and specificity of 88.5%, yielding a 50% positive predictive value and a 92.7% negative predictive value.
ETCOc on admission can help predict the duration of phototherapy in neonates with hyperbilirubinemia, facilitate clinicians to judge disease severity, and make clinical communication easier and more efficient.
本研究旨在评估经环境一氧化碳校正的呼末一氧化碳（ETCOc）值在重度高胆红素血症新生儿光疗中的预测性能。
对出生3至7天接受光疗的重度高胆红素血症新生儿进行前瞻性研究。对纳入婴儿入院时测量呼出气ETCOc和血清总胆红素。
103例重度高胆红素血症新生儿入院时的平均ETCOc为1.70 ppm。将新生儿分为两组：光疗时长≤72 h（n = 87）组和>72 h（n = 16）组。光疗>72 h的婴儿ETCOc显著更高（2.45对1.60，P = 0.001）。入院时预测更长光疗时长的ETCOc临界值为2.4 ppm，敏感性为62.5%，特异性为88.5%，阳性预测值为50%，阴性预测值为92.7%。
入院时的ETCOc有助于预测高胆红素血症新生儿的光疗时长，便于临床医生判断疾病严重程度，使临床沟通更轻松高效。
