Point-of-care end-tidal carbon monoxide reflects severity of hemolysis in sickle cell anemia

Pediatr Blood Cancer. 2015 May;62(5):912-4. doi: 10.1002/pbc.25447. Epub 2015 Feb 14.

Abstract

Carbon monoxide (CO) production from heme catabolism is increased with hemolysis. A portable end-tidal CO (ETCO) monitor was used to analyze breath samples in 16 children with sickle cell anemia (SCA, 5-14 years). Median (range) ETCO for SCA was 4.35 ppm (1.8-9.7) versus 0.80 ppm (0.2-2.3) for controls (P < 0.001). ETCOc >2.1 ppm provided sensitivity and specificity of 93.8% (69.8-99.8%) for detecting SCA. ETCO correlated with reticulocytosis (P = 0.015) and bilirubin (P = 0.009), and was 32% lower in children receiving hydroxyurea (P = 0.09). Point-of-care ETCO analysis may prove useful for non-invasive monitoring of hemolysis and as a screening test for SCA.

Keywords: hemoglobinopathies; red blood cell disorders; sickle cell anemia.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Anemia, Sickle Cell / physiopathology*
  • Bilirubin / analysis
  • Carbon Monoxide / analysis*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Exhalation / physiology*
  • Female
  • Follow-Up Studies
  • Hemolysis*
  • Humans
  • Male
  • Monitoring, Physiologic / instrumentation
  • Pilot Projects
  • Point-of-Care Systems
  • Prognosis
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Tidal Volume*

Substances

  • Carbon Monoxide
  • Bilirubin