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Association between blood carboxyhemoglobin level and bronchopulmonary dysplasia in extremely low birthweight infants
  1. Thea Tagliaferro,
  2. Rowena Cayabyab,
  3. Rangasamy Ramanathan
  1. Keck School of Medicine/Pediatrics/Division of Neonatology, USC, Los Angeles, California, USA
  1. Correspondence to Dr Thea Tagliaferro, Keck School of Medicine/ Pediatrics/ Division of Neonatology, USC, Los Angeles, CA 90033, USA; thea.tagliaferro{at}gmail.com

Abstract

Carboxyhemoglobin (CO-Hb) can be endogenously formed in the presence of oxidative stress and may be elevated in inflammatory lung disease. There is lack of evidence of its relationship with the development of bronchopulmonary dysplasia (BPD) in extremely low birthweight (ELBW) infants. The objective of the study is to evaluate the relationship between blood CO-Hb levels in the first 14 days of life (DOL) in ELBW infants and the development of BPD at 36 weeks postmenstrual age (PMA). This is a retrospective cohort study of 58 ELBW infants born at LAC-USC Medical Center between June 2015 and and June 2019 who survived to 36 weeks PMA. CO-Hb values were collected daily from DOL 1 to DOL 14. BPD definition using the recent 2019 NICHD criteria was used. Multivariate logistic regression was performed to determine the association between blood CO-Hb levels and BPD. Receiver operator curve was used to evaluate the ability of the median fraction of inspired oxygen (FiO2) level used at DOL 11–14 in discriminating absent to mild BPD versus moderate to severe BPD. 58 ELBW infants were included in the study. 24 (41%) were diagnosed with moderate to severe BPD, while 34 (59%) were diagnosed with no to mild BPD. Severity of BPD was fairly discriminated by FiO2 at DOL 11–14, but not with CO-Hb levels at any point within the first 14 DOL. The role and mechanism of CO-Hb production in this population need to be further studied.

  • infant
  • premature
  • lung diseases
  • newborn
  • diseases

Data availability statement

Data may be obtained from a third party and are not publicly available. Data were collected from an institutional neonatal database (Neonatal Information Systems (NIS 5), Rosemont, Philadelphia).

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Data availability statement

Data may be obtained from a third party and are not publicly available. Data were collected from an institutional neonatal database (Neonatal Information Systems (NIS 5), Rosemont, Philadelphia).

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Footnotes

  • Contributors TT, RC and RR conceptualized and designed the study, drafted the initial manuscript, reviewed and revised the manuscript. All authors approve the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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