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End-Tidal Carbon Monoxide V
Correlation of Reticulocyte Count and End-Tidal Carbon Monoxide Production with the Hematocrit Levels in Preterm Infants. Aouthmany MM. Mercy Children’s Hospital, Toledo OH.
Hemotocrits, reticulocyte counts, and ETCOc measurements were performed weekly on 32 stable preterm infants. Babies requiring significant blood draws or mechanical ventilation, and those with hemolytic disease, sepsis, or recent blood transfusions were excluded. The babies weighed 1595 +/- 441 grams at the time of enrollment, and were 46 +/- 29 days old. The Pearson correlation between hematocrit and reticulocyte count was r=-0.341 (p<0.005), and between hematocrit and ETCOc was r=0.444 (p<0.001). The author concluded that reticulocyte count and ETCOc measurements were "important for evaluating the hemoglobin status in preterm infants."
Comment. ETCOc measurements may be helpful in determining if anemia in a growing preterm infant is primarily an under-production problem (as seen in anemia of prematurity) or a problem with increased RBC degradation (as seen in vitamin E deficiency, for example). Reticulocyte count alone can be misleading in anemia of prematurity, as low or normal result is expected early, and a high normal result is seen as the baby is recovering.
Comment. Rarely do we see as much attention being paid to a single new technology in neonatology as end-tidal carbon monoxide (ETCOc) measurement is receiving this year. The use of ETCOc in the evaluation of neonates with hyperbilirubinemia was the subject of 5 different papers presented at this year’s AAP perinatal section meeting. Carbon monoxide is a byproduct of heme degradation, and it appears that exhaled levels of this gas are directly related to the amount of hemolytic disease present. Brief summaries of the other papers on this topic are linked here: 2-041; 2-042; 2-043; 2-044.