Point‐of‐care end‐tidal carbon monoxide reflects severity of hemolysis in sickle cell anemia

Carbon monoxide (CO) production from heme catabolism is increased with hemolysis. A portable end-tidal CO (ETCO) monitor was used to analyze breath samples in 16 children with sickle cell anemia (SCA, 5–14 years). Median (range) ETCO for SCA was 4.35 ppm (1.8–9.7) versus 0.80 ppm (0.2–2.3) for controls (P  2.1 ppm provided sensitivity and specificity of 93.8% (69.8–99.8%) for detecting SCA. ETCO correlated with reticulocytosis (P = 0.015) and bilirubin (P = 0.009), and was 32% lower in children receiving hydroxyurea (P = 0.09). Point-of-care ETCO analysis may prove useful for non-invasive monitoring of hemolysis and as a screening test for SCA. Pediatr Blood Cancer 2015;62:912–914. © 2015 Wiley Periodicals, Inc.