February 1974

Carboxyhemoglobin Determination in Evaluating Neonatal Jaundice

Author Affiliations

USA, Fort Lewis, Wash; Seattle
From the departments of pediatrics (Drs. Alden and Wennberg) and medicine (Dr. Lynch), University of Washington School of Medicine, Seattle. Dr. Alden is now with the Newborn Service, Madigan Army Medical Center, Fort Lewis, Wash. Dr. Lynch is now with the Department of Medicine, University of Witwatersrand, Johannesburg, South Africa.

Am J Dis Child. 1974;127(2):214-217. doi:10.1001/archpedi.1974.02110210064008

Carboxyhemoglobin levels were higher in patients with hemolytic disease (Rh isoimmunization) than in normal infants born of nonsmoking mothers, both at birth and during the first day of life. In these patients, postnatal carboxyhemoglobin levels correlated with the rate of bilirubin rise and the need for exchange transfusion. Nine infants with idiopathic hyperbilirubinemia and normal carboxyhemoglobin levels had no evidence for increased hemolysis, whereas seven jaundiced infants with elevated carboxyhemoglobin concentrations had conditions likely to cause hemolysis.

Carboxyhemoglobin determination may be helpful in (1) predicting the need for exchange transfusion in erythroblastotic infants and (2) differentiating hemolytic from nonhemolytic causes of neonatal jaundice.