Endogenous carbon monoxide production in patients with hemolytic anemia.

It is desirable in many studies to be able to rapidly measure rates of erythrocyte and hemoglobin destruction. Labeling techniques have been utilized for this purpose but have the disadvantage of requiring several days' to weeks to obtain the desired data plus the hazards of radioactive isotopes. Estimations of hemoglobin turnover from measurements of fecal bile pigment or serum bilirubin concentrations contain large sources of error (1). Studies in which bile pigment is collected via bile duct fistulas have been of value in animal experiments (2) but are -not usually possible in man, and subjects who have bile fistulas cannot be called normal. At the present time it appears that many in vivo investigations of red cell survival in patients with hemolytic disease are limited by the lack of a precise rapid method for detecting changes in the rate of red cell destruction. It has been shown previously (3-9) that CO is an in vivo catabolic by-product of hemoglobin and