Changes of electroencephalographic activities during fully automated simultaneous peripheral arteriovenous exchange transfusion in neonates with hyperbilirubinemia / 中华实用儿科临床杂志

ABSTRACT

Objective To analyze the changes of electroencephalographic activities during fully automated simultaneous peripheral arteriovenous exchange transfusion(ET) in neonates with hyperbilirubinemia.Methods A total of 45 neonates who suffered from severe hyperbilirubinemia and underwent fully automated simultaneous peripheral arteriovenous exchange transfusion were studied from March 2009 to March 2016 in Neonatal Intensive Care Unit of Guangzhou Women and Children's Medical Center,and 46 ETs were performed in 45 babies who were divided into 2 groups according to the severity of hyperbilirubinemiathe encephalopathy group and the none-encephalopathy group.Nineteen patients were in the encephalopathy group,in which 11 were male and 8 were female.The other 26 patients were in the none-encephalopathy group,in which 15 were male and 11 were female.Changes in amplitude integrated electroencephalogram(aEEG) during ETs were analyzed,including background activities,sleep-wake cycle (SWC)and seizures.Results Forty-five patients with hyperbilirubinemia underwent 46 fully automated simultaneous peripheral arteriovenous ETs.As a result,total bilirubin dropped from (524.90 ± 110.96)μmol/L before ETs to (245.62 ±78.97) μmol/L after ETs,with clearance rate of 53.2％.And indirect bilirubin dropped from(486.16 ±90.39) μmol/L before ETs to(222.19 ± 79.49) μmoL/L after ETs,with clearance rate of 54.3％.On the other hand,there was no significant difference in the changes of electroencephalographic activities during ETs,including background activities (x2 =0.16,P ＞ 0.05),SWC (x2 =0.71,P ＞ 0.05) and seizures (x2 =0.30,P ＞ 0.05).However,there were significant difference in suppressions on background activities between the encephalopathy group and the none-encephalopathy group(Fisher's exact test P =0.042),though there were no significant statistical differences in SWC or seizures between the 2 groups (x2 =0.65,P ＞ 0.05;x2 =2.07,P ＞ 0.05,respectively).Conclusions In neonatal hyperbilirubinemia,fully automated simultaneous peripheral arteriovenous ET is safe and efficient without significant influence on electroencephalographic activities as a whole.However,background activities are more significantly depressed in infants of bilirubin encephalopathy than that of non-encephalopathy during ET.