Blood Level of Carboxyhemoglobin in Indirect Hyperbilirubinemia in Term and Late Preterm Infants as a Marker of Hemolysis

Abstract

eonatal hyperbilirubinemia is the most common clinical condition in the newborn requiring evaluation and management and remains a frequent reason for hospital readmission during the first week of life. Newborns who develop severe hyperbilirubinemia are at risk for neurological complication. As most of the laboratory tests available for detecting hemolysis are indirect and unreliable, this study aims to investigate whether COHb measurement is a good marker and could be used as an indicator for hemolysis and early indicator for severity of hemolysis in newborns. This study was carried out on 42 term and late-preterm neonates with gestational age ≥ 35 weeks who were recruited from Neonatal Intensive Care Unit of Ain Shams University Children hospital and Obstetrics and Gynaecology Hospital of Ain Shams University, Cairo, Egypt. All infants were subjected to history, clinical examination, initial labs and COHb measured by blood gas CO-oximetry on admission and after 48hours with followe up labs. Our study showed significant difference in COHb level on admission which increase with total serum bilirubin level on admission and positive direct Coombs test, and high significant difference with decreased Hb on admission, decreased Hb at 48 h, increased TLC, increased reticulocytes, increa