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Clinical Chemistry, Vol 40, 1934-1939, Copyright © 1994 by American Association for Clinical Chemistry
DK Stevenson, HJ Vreman, W Oh, AA Fanaroff, LL Wright, JA Lemons, J Verter, S Shankaran, JE Tyson and SB Korones
Department of Pediatrics, Stanford University School of Medicine, CA 94305-54119.
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 microL/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 microL/L, than for those who had a positive Coombs' test result but whose bilirubin was < or = 130 mg/L (n = 12), 1.0 +/- 0.5 microL/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 microL/L, significantly higher than that in the other term infants [1.3 +/- 0.7 microL/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.
The following articles in journals at HighWire Press have cited this article:
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  J. M Kirk Neonatal jaundice: a critical review of the role and practice of bilirubin analysis Ann Clin Biochem, September 1, 2008; 45(5): 452 - 462. [Abstract] [Full Text] [PDF]
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 M. J. Maisels and E. Kring The Contribution of Hemolysis to Early Jaundice in Normal Newborns Pediatrics, July 1, 2006; 118(1): 276 - 279. [Abstract] [Full Text] [PDF]
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 L. Wu and R. Wang Carbon Monoxide: Endogenous Production, Physiological Functions, and Pharmacological Applications Pharmacol. Rev., December 1, 2005; 57(4): 585 - 630. [Abstract] [Full Text] [PDF]
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 C M Harrison and C C Andersen Exhaled breath measures of inflammation: are they useful in neonatal chronic lung disease? Arch. Dis. Child. Fetal Neonatal Ed., January 1, 2005; 90(1): F6 - F10. [Abstract] [Full Text] [PDF]
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M. Kaplan, M. Herschel, C. Hammerman, J. D. Hoyer, and D. K. Stevenson Hyperbilirubinemia Among African American, Glucose-6-Phosphate Dehydrogenase-Deficient Neonates Pediatrics, August 1, 2004; 114(2): e213 - e219. [Abstract] [Full Text] [PDF]
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 A. Madan, K. Huntsinger, A. Burgos, and W. E. Benitz Readmission for Newborn Jaundice: The Value of the Coombs' Test in Predicting the Need for Phototherapy Clinical Pediatrics, January 1, 2004; 43(1): 63 - 68. [Abstract] [PDF]
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M. Kaplan, M. Muraca, C. Hammerman, F. F. Rubaltelli, M. T. Vilei, H. J. Vreman, and D. K. Stevenson Imbalance Between Production and Conjugation of Bilirubin: A Fundamental Concept in the Mechanism of Neonatal Jaundice Pediatrics, October 1, 2002; 110(4): e47 - 47. [Abstract] [Full Text] [PDF]
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D. K. Stevenson, A. A. Fanaroff, M. J. Maisels, B. W. Y. Young, R. J. Wong, H. J. Vreman, J. R. MacMahon, C. Y. Yeung, D. S. Seidman, R. Gale, et al. Prediction of Hyperbilirubinemia in Near-Term and Term Infants Pediatrics, July 1, 2001; 108(1): 31 - 39. [Abstract] [Full Text] [PDF]
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 P. A. Dennery, D. S. Seidman, and D. K. Stevenson Neonatal Hyperbilirubinemia N. Engl. J. Med., February 22, 2001; 344(8): 581 - 590. [Full Text] [PDF]
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D. K. Stevenson and H. J. Vreman Carbon Monoxide and Bilirubin Production in Neonates Pediatrics, August 1, 1997; 100(2): 252 - 259. [Full Text] [PDF]
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