AUTHOR=Zhan Yuan-Li , Peng Hai-Bo , Jin Zhen-Chao , Su Jin-Feng , Tan Xiang-Yu , Zhao Lu , Zhang Lian 

TITLE=Higher ETCOc predicts longer phototherapy treatment in neonatal hyperbilirubinemia

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1154350

DOI=10.3389/fped.2023.1154350

ISSN=2296-2360

ABSTRACT=Objective: This study aimed to evaluate the predictive performance of end-tidal carbon monoxide corrected to ambient carbon monoxide (ETCOc) values phototherapy in neonates with significant hyperbilirubinemia.
Methods: A prospective study was conducted on neonates with significant hyperbilirubinemia who received phototherapy between 3 and 7 days of life. The breath ETCOc and serum total bilirubin of the recruited infants were measured on admission. 
Results: The mean ETCOc at admission in 103 neonates with significant hyperbilirubinemia was 1.70 ppm. The neonates were categorized into two groups: phototherapy duration ≤72 h (n=87) and >72 h (n=16) groups.Infants who received phototherapy for >72 h had significantly higher ETCOc (2.45 vs. 1.60, P=0.001). The cutoff value of ETCOc on admission for predicting longer phototherapy duration was 2.4 ppm, with a sensitivity of 62.5% and specificity of 88.5%, yielding a 50% positive predictive value and a 92.7% negative predictive value. 
Conclusion: ETCOc on admission can help predict the duration of phototherapy in neonates with hyperbilirubinemia, facilitate clinicians to judge disease severity, and make clinical communication easier and more efficient.