All issues > Volume 31(5); 1988

Original Article

J Korean Pediatr Soc. 1988;31(5):547-554. Published online May 31, 1988.

Changes in Auditory Brainstem Resposes in Hyperbilirubinemic Neonates Before and after Exchange Transfussion and Phototherapy.

Chong Woo Bae¹, Young Ho Ra¹, Sa Jun Chung¹, Chang Il Ahn¹

¹Department of Pediatrics, School of Medicine, Kyung Hee University, Seoul, Korea

Received: December 31, 1987;  Accepted: January 5, 1988.

Abstract

More recently, several studies of newborns involving ABR testing have demonstrated abnormalities following an exposure to moderate or severe hyperbilirubinemia. Jaundice in the early neonatal period is associated with significant transient aberrations of ABR, which suggested transient brain- stem encephalopathy. So, many authors mentioned that ABR may be a useful tool for the monitoring of early biliubin toxicity in infants who were at risk for jaundice. We have studied the findings and changes of ABR before and after exchatransfusion (ET) in 15 severe hyperbilirbimenic neonates, of ABR in 15 moderate hyperbilirubinemic neotates who were treated by only phototherapy (PT) and 15 normal control neonates. The following results were obtained 1) Mean bilirubin concentration were 20.7 ± —4.5 mg/dl in ET group and 16.0 ±2.5 mg/dl in PT group. There were no difference of hemoglobin and hematocrit level between ET and PT group. 2) Changes of ABR in ET group ① In 4 neonates among 15 ET group, wave complex IV-V was absent before ET but appeared in the recording after ET. ② Peak latencies of wave I, III, IV-V before ET were 2.09±0.18, 4.86±0.49, 7.65±0.16 msec and after ET were 1.72±0.30, 4.35±0.30, 6.97±0.21 msec and 1.89±0.38, 4.89±0.59, 7.18±0.72 msec in normal control group. There were significant shortening of peak latencies of wave I，III，IV-V after ET compared with before ET (p<0.01). There were significnat prolongation of peak latencies of wave I, IV-V before ET compared with normal control group (I: p<0.01, IV-V： p<0.01). ③ Interpeak latencies (IPLS) of wave I -III, III-IV,V, I -IV,V before ET were 2.77±0.19, 2.79±0.29, 5.57 ±0.24 msec, after ET were 2.61 ±0.23, 2.580.26, 6.97 ±0.21 msec., and 2.49 ±0.54, 2.29 ±0.59, 5.29± 0.71 msec in normal control group. There were significant shortening of wave I-III, III IV,V, I 4V，V IPLS after ET compared with before ET (p<0.05). There were significant prolongation of wave I - III, III-IV,V, I -IV, V IPLS before ET compared with normal control group (p<0.05). ④ There were no changes of amplitude before and after ET. 3) Changes of ABR in PT group There were no significant changes of peak latencies, IPLS and amplitude between before and after PT. 4) In conclusion, severe neonatal hyperbilirubinemia who were required ET was associated with significant transient aberrations of ABR, suggestive of transient brainstem encephalopathy and ABR has potential utility in detection of acute brain toxicity of bilirubin.

Keywords :ABR, Hyperbilirubinemia of New bom, Bilirubin Encephalopathy