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Reference intervals for end-tidal carbon monoxide of preterm neonates

Journal of Perinatology volume 42, pages 116–120 (2022)Cite this article

Subjects

Abstract

Objectives

We constructed reference intervals for end-tidal carbon monoxide (ETCOc) levels of neonates 28 0/7 to 34 6/7 weeks gestation in order to assess hemolytic rate.

Study design

This is a prospective four-NICU study in Bangkok, Thailand, and Utah, USA.

Results

Of 226 attempted measurements, 92% were successful. Values from day 1 through 28 were charted and upper (>95th percentile) reference interval limits calculated. During the entire 28 days, the ETCOc upper reference intervals from babies in Bangkok were higher than those in Utah (p < 0.01). No differences were found due to sex, or earliest vs. latest gestation at birth (both p > 0.1). Similar to term neonates, preterm neonates in Bangkok and Utah had higher ETCOc values during the first 48 h after birth than thereafter (p < 0.01).

Conclusions

Using this methodology, and the reference interval chart, the hemolytic rate of preterm infants ≥28 weeks can be assessed.

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Fig. 1: Upper reference interval (95th percentile) for ETCOc of preterm infants 28 0/7 through 34 6/7 weeks gestation at birth, during the first 28 days after birth.

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Code availability

The computer code used for statistical analysis is available by request from the corresponding author.

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Author information

Authors and Affiliations

  1. Ramathibodi Hospital and Chakari Nareubodindra Institute, Bangkok, Thailand

    Sasikarn Pakdeeto, Sarayut Supapannachart, Pracha Nuntnarumit & Saranya Sukwiset

  2. Division of Neonatology, Department of Pediatrics, Mahidol University, Bangkok, Thailand

    Sasikarn Pakdeeto, Sarayut Supapannachart, Pracha Nuntnarumit & Saranya Sukwiset

  3. University of Utah, Salt Lake City, UT, USA

    Thomas R. Christensen

  4. Department of Neonatology, Intermountain Healthcare, Murray, UT, USA

    Timothy M. Bahr, Erick Gerday & Mark J. Sheffield

  5. Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA

    Timothy M. Bahr, Robin K. Ohls & Robert D. Christensen

  6. Women and Newborn Research, Intermountain Healthcare, Salt Lake City, UT, USA

    Timothy M. Bahr & Robert D. Christensen

  7. Brigham Young University, Provo, UT, USA

    Kyle S. Christensen

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  1. Sasikarn Pakdeeto
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Contributions

SP: conception and design, collection and assembly of data, data analysis and interpretation, manuscript writing, editing and final approval of manuscript. TRC: collection and assembly of data, data analysis and interpretation, manuscript writing, editing and final approval of manuscript. TMB: conception and design, collection and assembly of data, data analysis and interpretation, manuscript writing, editing and final approval of manuscript. EG: conception and design, collection and assembly of data, editing and final approval of manuscript. MJS: conception and design, collection and assembly of data, editing and final approval of manuscript. KSC: collection and assembly of data, data analysis and interpretation, editing and final approval of manuscript. S. Supapannachart: conception and design, collection and assembly of data, editing and final approval of manuscript. PN: conception and design, collection and assembly of data, editing and final approval of manuscript. S. Sukwiset: conception and design, collection and assembly of data, editing and final approval of manuscript. RKO: conception and design, collection and assembly of data, data analysis and interpretation, editing and final approval of manuscript. RDC: conception and design, collection and assembly of data, data analysis and interpretation, manuscript writing, editing and final approval of manuscript.

Corresponding author

Correspondence to Timothy M. Bahr.

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Competing interests

CoSense End Tidal CO monitors and Precision Sampling Sets were provided by Capnia, Inc, Foster City, CA, USA. None of the authors has any conflict of interest.

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Pakdeeto, S., Christensen, T.R., Bahr, T.M. et al. Reference intervals for end-tidal carbon monoxide of preterm neonates. J Perinatol 42, 116–120 (2022). https://doi.org/10.1038/s41372-021-01207-2

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