接受ET的新生婴儿脑功能的急性变化尚不清楚。本研究旨在确定全自动同步外周动静脉ET是否会影响脑功能。
对39例接受ET治疗的高胆红素血症新生儿的临床资料进行回顾性分析。脑病组17例,其他22例患者为非脑病组。分析了ET过程中振幅整合脑电图(aEEG)的变化,包括背景活动,睡眠-觉醒循环(SWC),和癫痫发作。ET前后,血常规检查参数,电解质,血糖,并测定血气参数。
在ET之后,pH值没有显著变化,PaO2,PaCO2,乳酸,和红细胞,而总胆红素的水平,间接胆红素,血钾,血钠,血清钙,而血细胞,与治疗前相比,血小板显着降低,血糖水平显着升高。ETs期间脑电图活动的变化没有显着差异,包括背景活动,SWC,和癫痫发作。然而,对背景活动的抑制存在显着差异,而两组间SWC或癫痫发作无显著统计学差异。
全自动同步外周动静脉ET是安全有效的,对ET后新生儿的内环境和脑电图活动无明显影响。然而,在ET期间,胆红素脑病婴儿的背景活动比非脑病婴儿的背景活动更明显。
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.
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.
After ETs, there were no significant changes in the levels of pH, PaO2, PaCO2, 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 ETs, including background activities, SWC, and seizures. However, there were significant differences in suppressions on background activities, while there were no significant statistical differences in SWC or seizures between the 2 groups.
Fully automated simultaneous peripheral arteriovenous ET is safe and efficient without significant influence on the disorder of the internal environment and electroencephalographic activities after ET in neonates. However, background activities are more significantly depressed in infants of bilirubin encephalopathy than infants of non-encephalopathy during ET.