Bilirubin production in healthy term infants as measured by carbon monoxide in breath

David K. Stevenson, Hendrik J. Vreman, William Oh, Avroy A. Fanaroff, Linda L. Wright, James A. Lemons, Joel Verter, Seetha Shankaran, Jon E. Tyson, Sheldon B. Korones, Charles R Bauer, Barbara J. Stoll, Lu Ann Papile, Felix Okah, Richard A. Ehrenkranz

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Abstract

To describe total bilirubin production in healthy term infants, we measured the end-tidal breath CO, corrected for ambient CO (ETCOc), with an automated sampler and electrochemical (EC) CO instrument. For infants of mothers with a negative Coombs' test, the ETCOc was 1.3 ± 0.7 μL/L (n = 397) and the serum bilirubin on day 3 postpartum was 73 ± 35 mg/L (n = 381). In contrast, the ETCOc for infants with ABO or Rh incompatibility, a positive direct Coombs' test, and bilirubin > 130 mg/L (n = 9) was significantly higher, 1.8 ± 0.8 μL/L, than for those who had a positive Coombs' test result but whose bilirubin was ≤130 mg/L (n = 12), 1.0 ± 0.5 μL/L (P <0.05). At 2 to 8 h postpartum seven term babies from mothers with insulin- dependent diabetes had ETCOc of 1.8 ± 0.7 μL/L, significantly higher than that in the other term infants [1.3 ± 0.7 μL/L (n = 390), P <0.04]. Their bilirubin concentration at 72 ± 12 h was also higher: 121 ± 45 mg/L (n = 7) vs 73 ± 34 mg/L (n = 374; P = 0.03). We conclude that ETCOc measurements may be helpful in understanding the mechanisms of jaundice in healthy term infants in a variety of conditions.

Original languageEnglish
Pages (from-to)1934-1939
Number of pages6
JournalClinical Chemistry
Volume40
Issue number10
StatePublished - Oct 18 1994

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Carbon Monoxide
Bilirubin
Coombs Test
Postpartum Period
Mothers
Medical problems
Jaundice
Insulin
Serum

ASJC Scopus subject areas

  • Clinical Biochemistry

Cite this

Stevenson, D. K., Vreman, H. J., Oh, W., Fanaroff, A. A., Wright, L. L., Lemons, J. A., ... Ehrenkranz, R. A. (1994). Bilirubin production in healthy term infants as measured by carbon monoxide in breath. Clinical Chemistry, 40(10), 1934-1939.

Bilirubin production in healthy term infants as measured by carbon monoxide in breath. / Stevenson, David K.; Vreman, Hendrik J.; Oh, William; Fanaroff, Avroy A.; Wright, Linda L.; Lemons, James A.; Verter, Joel; Shankaran, Seetha; Tyson, Jon E.; Korones, Sheldon B.; Bauer, Charles R; Stoll, Barbara J.; Papile, Lu Ann; Okah, Felix; Ehrenkranz, Richard A.

In: Clinical Chemistry, Vol. 40, No. 10, 18.10.1994, p. 1934-1939.

Research output: Contribution to journalArticle

Stevenson, DK, Vreman, HJ, Oh, W, Fanaroff, AA, Wright, LL, Lemons, JA, Verter, J, Shankaran, S, Tyson, JE, Korones, SB, Bauer, CR, Stoll, BJ, Papile, LA, Okah, F & Ehrenkranz, RA 1994, 'Bilirubin production in healthy term infants as measured by carbon monoxide in breath', Clinical Chemistry, vol. 40, no. 10, pp. 1934-1939.
Stevenson DK, Vreman HJ, Oh W, Fanaroff AA, Wright LL, Lemons JA et al. Bilirubin production in healthy term infants as measured by carbon monoxide in breath. Clinical Chemistry. 1994 Oct 18;40(10):1934-1939.
Stevenson, David K. ; Vreman, Hendrik J. ; Oh, William ; Fanaroff, Avroy A. ; Wright, Linda L. ; Lemons, James A. ; Verter, Joel ; Shankaran, Seetha ; Tyson, Jon E. ; Korones, Sheldon B. ; Bauer, Charles R ; Stoll, Barbara J. ; Papile, Lu Ann ; Okah, Felix ; Ehrenkranz, Richard A. / Bilirubin production in healthy term infants as measured by carbon monoxide in breath. In: Clinical Chemistry. 1994 ; Vol. 40, No. 10. pp. 1934-1939.
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abstract = "To describe total bilirubin production in healthy term infants, we measured the end-tidal breath CO, corrected for ambient CO (ETCOc), with an automated sampler and electrochemical (EC) CO instrument. For infants of mothers with a negative Coombs' test, the ETCOc was 1.3 ± 0.7 μL/L (n = 397) and the serum bilirubin on day 3 postpartum was 73 ± 35 mg/L (n = 381). In contrast, the ETCOc for infants with ABO or Rh incompatibility, a positive direct Coombs' test, and bilirubin > 130 mg/L (n = 9) was significantly higher, 1.8 ± 0.8 μL/L, than for those who had a positive Coombs' test result but whose bilirubin was ≤130 mg/L (n = 12), 1.0 ± 0.5 μL/L (P <0.05). At 2 to 8 h postpartum seven term babies from mothers with insulin- dependent diabetes had ETCOc of 1.8 ± 0.7 μL/L, significantly higher than that in the other term infants [1.3 ± 0.7 μL/L (n = 390), P <0.04]. Their bilirubin concentration at 72 ± 12 h was also higher: 121 ± 45 mg/L (n = 7) vs 73 ± 34 mg/L (n = 374; P = 0.03). We conclude that ETCOc measurements may be helpful in understanding the mechanisms of jaundice in healthy term infants in a variety of conditions.",
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AU - Wright, Linda L.

AU - Lemons, James A.

AU - Verter, Joel

AU - Shankaran, Seetha

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AU - Korones, Sheldon B.

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AU - Ehrenkranz, Richard A.

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N2 - To describe total bilirubin production in healthy term infants, we measured the end-tidal breath CO, corrected for ambient CO (ETCOc), with an automated sampler and electrochemical (EC) CO instrument. For infants of mothers with a negative Coombs' test, the ETCOc was 1.3 ± 0.7 μL/L (n = 397) and the serum bilirubin on day 3 postpartum was 73 ± 35 mg/L (n = 381). In contrast, the ETCOc for infants with ABO or Rh incompatibility, a positive direct Coombs' test, and bilirubin > 130 mg/L (n = 9) was significantly higher, 1.8 ± 0.8 μL/L, than for those who had a positive Coombs' test result but whose bilirubin was ≤130 mg/L (n = 12), 1.0 ± 0.5 μL/L (P <0.05). At 2 to 8 h postpartum seven term babies from mothers with insulin- dependent diabetes had ETCOc of 1.8 ± 0.7 μL/L, significantly higher than that in the other term infants [1.3 ± 0.7 μL/L (n = 390), P <0.04]. Their bilirubin concentration at 72 ± 12 h was also higher: 121 ± 45 mg/L (n = 7) vs 73 ± 34 mg/L (n = 374; P = 0.03). We conclude that ETCOc measurements may be helpful in understanding the mechanisms of jaundice in healthy term infants in a variety of conditions.

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