The pathophysiology of the exaggerated hyperbilirubinemia in premature infants remains unclear. The relative contribution of bilirubin production may be estimated by measuring the pulmonary excretion rate of carbon monoxide (VeCO) We found that the mean Veco of premature infants, 16.7 ± 5.0 μl/kg/h, was significantly elevated (p < 0.05) compared with the mean VeCO of full-term infants, 13.9 ± 3.5 μl/kg/h. Premature infants who required phototherapy had a significantly (p < 0.05) higher mean VeCO than those who did not. The VeCO did not correlate with gestational age, implying that factors which associate frequently but variably with gestational age may have an important influence on heme catabolism.
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