Fully automated simultaneous peripheral arteriovenous exchange transfusion not seen to aggravate brain function and the disorder of the internal environment in neonates with severe hyperbilirubinemia

Abstract

Background: The acute changes in brain function in newborn infants undergoing ET remain unclear. This study aimed to determine whether fully automated simultaneous peripheral arteriovenous ET would influence the brain function. Methods: A retrospective analysis was conducted on the clinical data of 39 neonates with hyperbilirubinemia who received ET. Seventeen patients were in the encephalopathy group, and the other 22 patients were in the non-encephalopathy group. Changes in amplitude-integrated electroencephalogram (aEEG) during ETs were analyzed, including background activities, sleep-wake cycling (SWC), and seizures. Before and after the ET, routine blood test parameters, electrolytes, blood glucose, and blood gas parameters were measured. Results: After ETs, there were no significant changes in the levels of pH, PaO 2 , PaCO 2 , lactate, and red blood cells, while the levels of total bilirubin, indirect bilirubin, blood potassium, blood sodium, serum calcium, while blood cells, and platelets were significantly lower and the level of blood glucose was significantly higher compared to those before therapy. There was no significant difference in the changes of electroencephalographic activities during

Fully automated simultaneous peripheral arteriovenous exchange transfusion not seen to aggravate brain function and the disorder of the internal environment in neonates with severe hyperbilirubinemia

“…In a recent study, Lu et al reported the results of fully automated simultaneous peripheral arteriovenous exchange transfusion (ET) on brain function and internal environment in neonates with severe hyperbilirubinemia. 1 In this study involving 39 neonates with hyperbilirubinemia, findings were made that automated simultaneous peripheral arteriovenous ET therapy could significantly reduce the concentration of direct bilirubin (DB) and total bilirubin (TB), and had no significant effect on the internal environment and neurological function. The authors undoubtedly made great efforts and provided novel insights for the treatment of neonates with hyperbilirubinemia.…”

Reply - Fully automated simultaneous peripheral arteriovenous exchange transfusion not seen to aggravate brain function and the disorder of the internal environment in neonates with severe hyperbilirubinemia

“…As a reply to the response letter 1 for our recent article entitled, "Fully automated simultaneous peripheral arteriovenous exchange transfusion not seen to aggravate brain function and the disorder of the internal environment in neonates with severe hyperbilirubinemia, 2 " firstly, we should emphasize that levels of indirect bilirubin (IDB) before and after exchange transfusion (ET) therapy were compared, not direct bilirubin (DB) as mentioned in the letter. To the best of our knowledge, the greatest risk of neonatal jaundice is the progression to bilirubin encephalopathy or kernicterus.…”