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End tidal carbon monoxide concentration in childhood haemolytic disorders
Author(s) -
CHAN GCF,
LAU YL,
YEUNG CY
Publication year - 1998
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1046/j.1440-1754.1998.00270.x
Subject(s) - medicine , carbon monoxide , carboxyhemoglobin , gastroenterology , anesthesia , biochemistry , chemistry , catalysis
Objectives: Endogenous carbon monoxide (CO) is produced mainly by heme catabolism. As CO is excreted solely by the lung, a simple technique for measuring the end tidal carbon monoxide (ETCO) level was assessed as a method for screening for haemolytic disease in children. Methods: Two end expiratory breath samples were collected from normal children and from children with haemolytic disease using a one way valve connector between a mouth piece and an anaesthetic bag. The samples were analysed by gas chromatography for CO and carbon for dioxide (CO 2 ). The CO 2 value was used to normalise the CO value to an alveolar concentration. Carboxyhaemoglobin (HbCO) also was measured in the patient group for correlation analysis with ETCO. Results: A total of 21 children with β thalassaemia major, 15 children with other haemolytic diseases (hereditary spherocytosis n =8, haemoglobin H disease n =3 and thalassaemia intermedia n =4) and 23 normal children were studied. The mean ETCO concentrations in the three groups were 3.21 p.p.m., 7.41 p.p.m. and 0.69 p.p.m., respectively, which were significantly different from each other ( P <0.0001). There was a significant correlation between ETCO and HbCO in the patient groups ( r =0.85; P <0.0001). Conclusions: The end expiratory breath collection device is a simple and feasible sample collection method. The results confirm that ETCO can be used clinically to distinguish children with a variety of haemolytic disorders from normal subjects.