الفهرس 
Neonatal HyperbilirubinemiaOnly 14 pages are availabe for public view
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Abstract
Neonatal hyperbilirubinemia is the most common clinical condition in the newborn requiring evaluation and management. It remains a frequent reason for hospital admission during the first week of life. Newborns who develop severe hyperbilirubinemia are at risk for development of neurological complications. Most laboratory tests available for detecting hemolysis are indirect and unreliable or needs special precautions.
Aim of the study: This study aims to investigate whether carboxy-hemoglobin (COHb) measurement is a good marker and could be used as an indicator for hemolysis.
Patients and methods: 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’s hospital and from Obstetrics and Gynaecology Hospital of Ain Shams University, Cairo, Egypt. All infants were subjected to COHb measurement by blood gas CO-oximetry on admission and after 48 hours with follow up laboratory investigatios.
Results: There was a significant increase in COHb level on admission with increase total serum bilirubin level on admission (P-value=0.001), positive direct Coombs test (P-value<0.001), decrease Hb on admission (P-value<0.001), decrease Hb at 48 h (P-value<0.001), increase reticulocytes (P-value<0.001), increase LDH (P-value<0.001) and increase COHb at 48 h (P-value<0.001). Also, significant increase in COHb level at 48 h with decrease hemoglobin level at 48 h (P-value=0.002), increase reticulocytes (P-value<0.001), increase LDH (P-value<0.001). It also demonstrated that infants with hemolytic hyperbilirubinemia had significantly higher COHb values either on admission or at 48 h with mean of COHb on admission was 2.4±0.8% in hemolytic hyperbilirubinemia group versus 1.4±0.2% in non-hemolytic hyperbilirubinemia group and mean of COHb at 48 h was 2.0±0.5% in hemolytic hyperbilirubinemia group versus 1.2±0.2% in non-hemolytic hyperbilirubinemia group.
Conclusion: COHb measurement on admission or at 48 hours with blood gas CO-oximeter is sensitive and specific method for use as an indicator for hemolysis in neonates with hemolytic hyperbilirubinemia.