Serial Carboxyhemoglobin Levels and Its Relationship with Late Onset Sepsis in Preterm Infants: An Observational Cohort Study

Varal, İpek Güney; Doğan, Peli̇n

doi:10.1080/15513815.2019.1652377

Cited by 8 publications

(10 citation statements)

References 23 publications

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“…In addition, the COHb value of ≥ 2.05 was highly speci c (97.5%) for invasive bacterial infection. This nding was correlated with other studies' ndings that showed a positive relationship between carbon monoxide/carboxyhaemoglobin and sepsis [10,[23][24][25]. When applying the COHb cut-off value of ≥ 1.35% as a marker for neonatal sepsis in our data sheet as suggested by Varal & Dogan, we get a higher sensitivity of 83.7% and lower speci city of 56.3% as compared to their reported sensitivity and speci city (56% and 90%, respectively).…”

Section: Discussionsupporting

confidence: 90%

Carboxyhaemoglobin level in neonatal sepsis: A point of care test at paediatric emergency department

Al-Hinai,

Yazidi,

Jaju

et al. 2023

Preprint

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Carboxyhaemoglobin (COHb) which represents the fraction of carbon monoxide binding to haemoglobin become available as a point-of-care test at the emergency department. Sepsis and other inflammatory process are well-known inducers of heme oxygenase enzymes that cause heme catabolism which results in endogenous carbon monoxide production. Studies have shown that measuring carboxyhaemoglobin level could be of use in early detection of neonatal sepsis. Purpose: This study aims to assesses the rule of COHb as a biomarker for neonatal sepsis in the paediatric emergency department. Methods: This is a retrospective case-control study that looks at the COHb values in neonates presented with febrile illness at paediatric emergency. The neonates were then categorised into culture proven bacterial infections vs culture negative bacterial infections. Different variables were then studied between the two groups. Result: COHb levels were significantly raised at the initial presentation of neonatal sepsis regardless of gender, birth weight, or gestational age. In addition, the COHb value of ≥ 2.05 was highly specific (97.5%) for invasive bacterial infection. Moreover, the mean length of stay regardless of the final diagnosis was significantly higher in the neonate with COHb level ≥2.0 which adds a prognostic value. Conclusion: COHb might be a useful biochemical marker for risk stratification of neonatal sepsis. Further study is needed for better delineation of its clinical utilities.

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Section: Discussionsupporting

confidence: 90%

Carboxyhaemoglobin level in neonatal sepsis: A point of care test at paediatric emergency department

Al-Hinai,

Yazidi,

Jaju

et al. 2023

Preprint

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“…A COHb of 1.35% was found to have a sensitivity of 56% and a specificity of 90% to detect late-onset sepsis in this population. 15 A higher MetHb was noted in septic compared with nonseptic (3.2% vs. 1.7%) preterm infants, likely due to induction of NO formation by inflammatory cytokines and lipopolysaccharide and its subsequent interaction with hemoglobin. However, caution must be exercised before extrapolating these data to adults, cats, or dogs because fetal hemoglobin may be more susceptible to oxidative stress.…”

Section: Discussionmentioning

confidence: 86%

“…8 The exploration of COHb as a prognostic indicator for patients with respiratory disease has yielded mixed results. 2,[9][10][11][12][13][14][15] Methemoglobin (MetHb) results when 1 or more of the iron ions in hemoglobin are oxidized from the ferrous to the ferric state, preventing hemoglobin from binding oxygen. While a small amount of MetHb may form following the unloading of oxygen to tissues, most endogenous MetHb forms when NO interacts with hemoglobin.…”

Section: Introductionmentioning

confidence: 99%

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Retrospective evaluation of carboxyhemoglobin and methemoglobin levels in dogs and cats with respiratory disease

Wolf

Hess

Hering

et al. 2022

J Vet Emergen Crit Care

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Objective To evaluate carboxyhemoglobin (COHb) and methemoglobin (MetHb) levels in dogs and cats with respiratory disease in the ICU. Design Retrospective study. Setting University veterinary teaching hospital. Animals The ICU census was searched for dogs (n = 466) and cats (n = 97) hospitalized within the ICU between January 2016 and January 2019 in whom blood gas with co‐oximetry was performed. Dogs and cats were stratified into those with primary respiratory and nonrespiratory categories; the underlying cause of the disease was also noted. Venous blood gas, co‐oximeter, PaO2/FiO2 (PF ratio), physical examination findings, and outcome were recorded. Measurements and main results The median COHb and MetHb in dogs hospitalized in the ICU were 2.6% (0.1%–5.6%) and 1.1% (0.1%–2.9%), respectively. The median COHb and MetHb in cats hospitalized in the ICU were 2.2% (0.1%–5.4%) and 1.0% (0%–2.1%), respectively. Dogs with respiratory disease had a higher COHb than dogs without respiratory disease (median, 2.7% [range, 0.3%–5.0%] vs. 2.5% [0.1%–5.6%]; P = 0.0148). COHb was positively associated with survival in cats (median, 2.2% [range, 0.1%–5.4%] vs. 1.9% [0.1%–3.9%]; P = 0.0433). Both COHb and MetHb were higher in septic dogs than in nonseptic dogs (median COHb, 2.8% [range 0.3%–4.5%] vs. 2.6% [0.1%–5.6%]; P = 0.02 and median MetHb, 1.1% [0.1%–2.9%] vs. 1.1% [0.1%–2.4%]; P = 0.01, respectively). Conclusions There may be a positive association between COHb and respiratory disease in dogs; prospective studies are needed to evaluate this further. No association between COHb and respiratory disease in cats or MetHb and respiratory disease in either species was detected. Additional prospective studies are needed to determine whether COHb and MetHb are biomarkers for sepsis in dogs and whether COHb is an indicator of mortality in cats.

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“…For example, Guney et al reported that a COHb value of ≥1.35 had a sensitivity of 56.07% and specificity of 90% as a marker of LOS. 21 On the contrary, a study on preterm infants did not demonstrate increased COHb levels in sepsis. 22 Our current work shows that a cut-off value of >1.5% for COHb has a sensitivity of 64.94% and a specificity of 72.73%.…”

Section: Statistical Analysis "Ibm Spss Statistics Formentioning

confidence: 94%

Carboxyhemoglobin Levels in Preterm Neonatal Late-Onset Sepsis: To Predict or Not to Predict

Vardar

Özek

2023

Mediterr J Hematol Infect Dis

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Abstract Background: To evaluate carboxyhemoglobin (COHb) levels in diagnosing late-onset sepsis (LOS) in preterm neonates. Methods: The records of culture-positive LOS in preterm neonates hospitalized in NICU from January 2017 to July 2022 were reviewed.COHb levels, C-reactive protein, procalcitonin, and neutrophil to lymphocyte ratio of septic preterm infants were compared to controls. Serial COHb levels measured within six hours before or 24h after blood culture sampling, three to seven days prior, and three to five days after starting antimicrobial therapy were retrieved from patient records. Results: The study included 77 blood-culture-positive preterm infants and 77 non-septic controls. During the LOS episode, the COHb values were found to be significantly increased (median: 1.8, IQR: 1.4-2.5) when compared to the control group (median: 1.2, IQR: 0.8-1.6) (p < 0.001). ROC analysis yielded an AUC of 0.714 for COHb (95% CI: 0.631-0.796, p<0.001). At an optimal cut-off of >1.5%, the test’s sensitivity was 64.94%, the specificity was 72.73%, the positive predictive value was 70.42%, and the negative predictive value was 67.47%.LOS led to a dramatic rise followed by a decrease after the initiation of the antimicrobial therapy [1.8 (1.4-2.5) ] vs. [1.45 (0.2-4)] p<0.001. Conclusion: COHb levels increased at the beginning of LOS, decreasing in response to antibiotics. When used in conjunction with other sepsis biomarkers, the variation of COHb can be important in evaluating a LOS episode in preterm infants. COHb can be utilized as a quick, bedside approach for detecting LOS in preterm neonates in NICUs.

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Serial Carboxyhemoglobin Levels and Its Relationship with Late Onset Sepsis in Preterm Infants: An Observational Cohort Study

Cited by 8 publications

References 23 publications

Carboxyhaemoglobin level in neonatal sepsis: A point of care test at paediatric emergency department

Carboxyhaemoglobin level in neonatal sepsis: A point of care test at paediatric emergency department

Retrospective evaluation of carboxyhemoglobin and methemoglobin levels in dogs and cats with respiratory disease

Carboxyhemoglobin Levels in Preterm Neonatal Late-Onset Sepsis: To Predict or Not to Predict

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