CoSense is a portable, non-invasive device that rapidly and accurately measures carbon monoxide in the exhaled breath of newborns. The measurement of carbon monoxide is the gold standard for measuring hemolysis, a condition that, if left untreated, may lead to elevated levels of bilirubin in the blood and a range of neurodevelopmental disorders.1
Approximately 60% of healthy infants and 80% of premature infants have jaundice during the neonatal period.2,3 It has been widely reported that the presence of hemolysis in a newborn with jaundice is a predictor of adverse neurodevelopmental outcomes such as low IQ, auditory abnormalities and kernicterus. With ETCO data, physicians may be able to more quickly identify and manage newborns with jaundice who are at risk. The American Academy of Pediatrics Clinical Practice Guidelines already recommend the use of ETCO monitoring in infants with jaundice.4
CoSense is indicated for the monitoring of CO in exhaled breath. To administer the test, a clinician places the nasal cannula onto the patient and connects the other end into the CoSense device. Once a test is initiated, the CoSense monitor will identify a valid breath sample and measures the amount of CO in the breath sample. The CoSense monitor also measures and corrects for CO in the ambient environment.
Key Features of CoSense:
- Portable, non-invasive monitor
- Accurately identify newborns with hemolysis in approximately five minutes
- No need for daily calibration
Additional Applications of End-Tidal Carbon Monoxide Testing:
CoSense is FDA 510(k) cleared in the US and has CE mark approval in Europe.
One source of exogenous CO is smoking, which is extremely harmful to one’s health and is known to be a risk factor for many diseases in adulthood. Most smokers (around 80-90%) would like to quit but have not been able to do so. Due to the development of strong physical substance dependence to nicotine or psychological dependence to smoking, there is a need for smoking cessation programs. CoSense can be used in smoking cessation programs to determine if an individual has been smoking. Increased levels of CO are observed in smokers. CoSense can be used to motivate participants by charting their progress in the program.
Carbon Monoxide Poisoning:
Common sources of exogenous carbon monoxide include vehicle exhaust, malfunctioning heaters or poorly ventilated fires. Since carbon monoxide is a colorless, odorless gas, it is difficult to detect. Carbon monoxide poisoning is equally difficult to detect because the initial symptoms are often only headache, nausea and/or lightheadedness but may rapidly progress to coma or death if not detected. Use of a rapid, inexpensive, non-invasive device to measure patients’ carbon monoxide levels in hospital emergency rooms would result in a quick diagnosis of carbon monoxide poisoning as opposed to a misdiagnosis such as the flu. CoSense can also be used by emergency services to help identify patients who are suspected of having CO poisoning. Using CoSense can allow the patient to receive treatment more rapidly and may improve their odds of survival.
- Bhutani VK, Johnson L, Sivieri EM. Predictive Ability of a Predischarge Hour-specific Serum Bilirubin for Subsequent Significant Hyperbilirubinemia in Healthy Term and Near-term Newborns. Pediatrics 1999;103:6.
- Bhutani VK, Johnson L. A proposal to prevent severe neonatal hyperbilirubinemia and kernicterus. J Perinatol 2009;29 Suppl 1:S61-S67.
- Kumar RK. Neonatal jaundice. An update for family physicians. Aust Fam Physician 1999;28:679-682.
- Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004;114:297-316.
- Payer policies will vary and should be verified prior to treatment for limitations on diagnosis, coding or site of service requirements. The coding options listed within this guide are commonly used codes and are not intended to be an all-inclusive list. We recommend consulting your relevant manuals for appropriate coding options.
- Payment rates are based upon a large urban hospital (wage index >1) and full update (1.7%). Rates will vary by facility.