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- Publisher Website: 10.1038/sj.jp.7210702
- Scopus: eid_2-s2.0-0036345460
- PMID: 12082466
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Article: Evaluation of the direct antiglobulin (coombs’) test for identifying newborns at risk for hemolysis as determined by end-tidal carbon monoxide concentration (ETCOc); and comparison of the coombs’ test with ETCOc for detecting significant jaundice
Title | Evaluation of the direct antiglobulin (coombs’) test for identifying newborns at risk for hemolysis as determined by end-tidal carbon monoxide concentration (ETCOc); and comparison of the coombs’ test with ETCOc for detecting significant jaundice |
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Authors | |
Issue Date | 2002 |
Citation | Journal of Perinatology, 2002, v. 22, n. 5, p. 341-347 How to Cite? |
Abstract | Objective: First, to determine the sensitivity, specificity, and positive predictive value (PPV) of the direct antiglobulin test (DAT) for significant hemolysis in the neonate, as referenced to end-tidal carbon monoxide, the criterion standard for estimating the rate of hemolysis; and second, to evaluate the predictive value of the two procedures for significant jaundice. Design: Consecutive term newborns admitted to the nursery of an inner-city university hospital over a 15-week period. DAT screening by the Blood Bank was performed on all. End-tidal carbon monoxide levels were obtained at 12 ± 6 and at 24 ± 6 hours of age. Infants of nonsmoking mothers whose 12-hour exhaled carbon monoxide level was ≥95th percentile were defined as having significant hemolysis. Results: n = 660; DAT was positive in 23 (3.5%). Using the 12-hour end-tidal carbon monoxide ≥3.2 μl/l (≥95th percentile) as reference (n = 499 nonsmokers), the sensitivity of the DAT was 38.5% (10 of 26) and specificity 98.5% (466 of 473) for the detection of significant hemolysis. The PPV of the DAT for significant hemolysis at 12 hours was 58.8% (10 of 17). For significant jaundice the PPV of end-tidal carbon monoxide was greater than that for DAT (65.4% vs 52.9%), although not statistically so (p = 0.25). The negative predictive values were similar. Conclusion: DAT fails to identify over half of the cases of significant hemolysis that are diagnosed by end-tidal carbon monoxide. A neonate with a positive DAT has about a 59% chance of having significant hemolysis. End-tidal carbon monoxide may also provide a more sensitive index for predicting significant jaundice. |
Persistent Identifier | http://hdl.handle.net/10722/323769 |
ISSN | 2023 Impact Factor: 2.4 2023 SCImago Journal Rankings: 1.026 |
DC Field | Value | Language |
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dc.contributor.author | Herschel, Marguerite | - |
dc.contributor.author | Karrison, Theodore | - |
dc.contributor.author | Wen, Ming | - |
dc.contributor.author | Caldarelli, Leslie | - |
dc.contributor.author | Baron, Beverly | - |
dc.date.accessioned | 2023-01-13T02:59:13Z | - |
dc.date.available | 2023-01-13T02:59:13Z | - |
dc.date.issued | 2002 | - |
dc.identifier.citation | Journal of Perinatology, 2002, v. 22, n. 5, p. 341-347 | - |
dc.identifier.issn | 0743-8346 | - |
dc.identifier.uri | http://hdl.handle.net/10722/323769 | - |
dc.description.abstract | Objective: First, to determine the sensitivity, specificity, and positive predictive value (PPV) of the direct antiglobulin test (DAT) for significant hemolysis in the neonate, as referenced to end-tidal carbon monoxide, the criterion standard for estimating the rate of hemolysis; and second, to evaluate the predictive value of the two procedures for significant jaundice. Design: Consecutive term newborns admitted to the nursery of an inner-city university hospital over a 15-week period. DAT screening by the Blood Bank was performed on all. End-tidal carbon monoxide levels were obtained at 12 ± 6 and at 24 ± 6 hours of age. Infants of nonsmoking mothers whose 12-hour exhaled carbon monoxide level was ≥95th percentile were defined as having significant hemolysis. Results: n = 660; DAT was positive in 23 (3.5%). Using the 12-hour end-tidal carbon monoxide ≥3.2 μl/l (≥95th percentile) as reference (n = 499 nonsmokers), the sensitivity of the DAT was 38.5% (10 of 26) and specificity 98.5% (466 of 473) for the detection of significant hemolysis. The PPV of the DAT for significant hemolysis at 12 hours was 58.8% (10 of 17). For significant jaundice the PPV of end-tidal carbon monoxide was greater than that for DAT (65.4% vs 52.9%), although not statistically so (p = 0.25). The negative predictive values were similar. Conclusion: DAT fails to identify over half of the cases of significant hemolysis that are diagnosed by end-tidal carbon monoxide. A neonate with a positive DAT has about a 59% chance of having significant hemolysis. End-tidal carbon monoxide may also provide a more sensitive index for predicting significant jaundice. | - |
dc.language | eng | - |
dc.relation.ispartof | Journal of Perinatology | - |
dc.title | Evaluation of the direct antiglobulin (coombs’) test for identifying newborns at risk for hemolysis as determined by end-tidal carbon monoxide concentration (ETCOc); and comparison of the coombs’ test with ETCOc for detecting significant jaundice | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1038/sj.jp.7210702 | - |
dc.identifier.pmid | 12082466 | - |
dc.identifier.scopus | eid_2-s2.0-0036345460 | - |
dc.identifier.volume | 22 | - |
dc.identifier.issue | 5 | - |
dc.identifier.spage | 341 | - |
dc.identifier.epage | 347 | - |